# Utilization Management Behavioral Health Professional 2

**Company**: Humana
**Location**: Remote Nationwide
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $65,000 - $88,600 per year
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-Nationwide/Utilization-Management-Behavioral-Health-Professional_R-435129?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_e4a73ca1-08f

## Description

Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations.

You will work on assignments that are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities:

- Utilize 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.

- Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment.

- Understand department, segment, and organisational strategy and operating objectives, including their linkages to related areas.

- Make decisions regarding own work methods, occasionally in ambiguous situations, and require minimal direction and receive guidance where needed.

- Follow established guidelines/procedures.

Required Qualifications:

- Bachelor’s degree in nursing or a master's degree in a Human Services field with a professional individual or compact licensure in the state of Kentucky without disciplinary action.

- Three (3) or more years of post-degree clinical experience in private practice or other healthcare settings.

- Intermediate working knowledge using Microsoft Office Programs specifically Excel, PowerPoint, Outlook and Word, systems, platforms, and an ability to troubleshoot and resolve general technical difficulties.

- Exceptional oral and written, communication, and interpersonal skills with the ability to build rapport with internal and external customers and stakeholders.

Preferred Qualifications:

- Experience working within a managed care organisation or a health plan.

- Experience with utilisation review process.

- Experience with behavioural change, health promotion, coaching and wellness.

- Experience working with individuals with substance use diagnoses.

- Knowledge of community health and social service agencies and additional community resources.

- Knowledge of substance use disorders and recovery process.

Additional Information:

- This is a remote position.

- Workdays & Hours: Monday - Friday; 8:30 AM - 5:00 PM Eastern Time (ET).

- Travel is required for our Annual All Hands meeting occurring once per year, typically in the spring.

Scheduled Weekly Hours: 40

Pay Range: $65,000 - $88,600 per year

This job is eligible for a bonus incentive plan.

Description of Benefits: Humana, Inc. and its affiliated subsidiaries offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

## Skills

### Required
- Microsoft Office
- Excel
- PowerPoint
- Outlook
- Word
- clinical knowledge
- communication skills
- interpersonal skills

### Nice to have
- utilisation review process
- behavioural change
- health promotion
- coaching
- wellness
- substance use diagnoses
- community health
- social service agencies

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Source: [Apply at humana.wd5.myworkdayjobs.com](https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-Nationwide/Utilization-Management-Behavioral-Health-Professional_R-435129?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)