Manager, Utilization Management Behavioral Health

Employment Type: Full-time Location Type: Remote Salary: $86,300 - $118,700 per year

Position Overview

Become a part of our caring community and help us put health first. The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. This role involves applying advanced technical knowledge to solve moderately complex problems, working within specific guidelines and procedures, and receiving assignments in the form of objectives to determine approach, resources, schedules, and goals. The Manager uses clinical knowledge, communication skills, and independent critical thinking to lead the team in providing the best and most appropriate treatment, care, or services for members. This role also involves coordinating and communicating with providers, members, or other parties to facilitate optimal care and treatment. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives within their departmental area. This position requires cross-departmental collaboration, conducting briefings and area meetings, and maintaining frequent contact with other managers across the department. Use your skills to make an impact!

Requirements

• Must Reside in Oklahoma
• Manager must hold one of the following licenses:
  • An active Licensed Registered Nurse (RN) in Oklahoma/multi-state, without restrictions.
  • A licensed Master’s Level Social Worker (LCSW, LMSW, LMSW-ACP, CSW, LPC, LMFT).
  • A Psychologist (PhD/EdD) in the State of Oklahoma without restrictions.
• 3+ years of post-degree clinical experience in direct patient care.
• 2+ years of case management and/or rehabilitative counseling experience.
• 2+ years of clinical supervisory experience.
• Previous experience in utilization management.
• Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook.

Preferred Qualifications

• Experienced with Milliman or Interqual criteria.

Additional Information

Work At Home Internet Statement

To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required.
• A wireless, wired cable, or DSL connection is suggested.
• Satellite, cellular, and microwave connections can be used only if approved by leadership.

Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

HireVue Statement

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Travel

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Compensation and Benefits

• Scheduled Weekly Hours: 40
• Bonus Incentive: This job is eligible for a bonus incentive plan based on company and/or individual performance.
• Benefits: Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole-person well-being. Associate benefits are designed to...