Manager, UM Behavioral Health

About the Role

Employment Type: Full time

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.

The Manager, Utilization Management Behavioral Health works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules, and goals.

The Manager, Utilization Management Behavioral Health uses clinical knowledge, communication skills, and independent critical thinking skills in interpreting criteria, policies, and procedures to lead the team 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.

Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration and conducts briefings and area meetings; maintains frequent contact with other managers across the department.

Use your skills to make an impact.

Required Qualifications

• Must Reside in Oklahoma
• Manager must be one of the following:
  • 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 of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection 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.

Schedule and Compensation

Scheduled Weekly Hours: 40

Pay Range: $86,300 - $118,700 per year 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.

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness.