[Hiring] Utilization Management Behavioral Health Professional @Humana

Role Description

The Utilization Management Behavioral Health Professional utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

• Uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care, or services for members.
• Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment.
• Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed.
• Follows established guidelines/procedures.

Qualifications

• Master's degree
• Board-Certified Behavioral Analysis
• Licensed Behavior Analyst (LBA) in Kentucky, Virginia, and Louisiana or willing to apply for licensure
• 2+ years of Applied Behavioral Analysis clinical experience
• Excellent verbal and written communication skills
• Working knowledge of MS Office including Word, Excel, and Outlook in a Windows-based environment
• Ability to quickly learn new systems and troubleshoot basic technical difficulties in a remote environment

Requirements

• 5 years' experience with Applied Behavioral Analysis (preferred)
• 1+ years of managed care experience (preferred)
• Knowledge of community health and social service agencies and additional community resources (preferred)

Benefits

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• Short-term and long-term disability
• Life insurance
• Many other opportunities

Scheduled Weekly Hours

• 40 hours per week

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full-time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job-related skills, knowledge, experience, education, certifications, etc.

• $65,000 - $88,600 per year
• This job is eligible for a bonus incentive plan based upon company and/or individual performance.