Utilization Management – Behavioral Health Professional Position Available In [Unknown county], Louisiana

Utilization Management – Behavioral Health Professional

Location:

Remote, Louisiana

Remote Job:

Remote Job:

Yes
widget:
Full time

Category:

Social Worker
undefined:
Humana

Job ID:

R-372917

Description
Be a part of our caringmunity and help us put health first
The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, andmunication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The Utilization Management Behavioral Health Professional 2 uses clinical knowledge,munication 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 andmunicates 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 w needed
Follows established guidelines/procedures
Use your skills to make an impact
Required Qualifications
Master’s level clinician with independent licensure in the state of Louisiana (i.e. Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapists (LMFTs) Licensed Addiction Counselors (LACs)
1+ year of managed care experience
Experience utilizing MCG and American Society of Addiction Medicine Criteria
Intermediate to advancedputer skills and experience with Microsoft Word, Excel and Outlook.
Ability to use a variety of electronic information applications/software programs including electronic medical records
Must be available to work 40-hour work week Monday – Friday 8:00-5:00 PM CST, potential for overtime with an expectation to cover a weekend and on-call rotation to meet business needs
Must reside in Louisiana and perform work within the state
Preferred Qualifications
2 years of direct care experience in an acute or outpatient behavioral health setting
Experience with Utilization Management or Prior Authorization
Experience with behavioral change, health promotion, coaching and wellness
Experience serving Medicare, Medicaid, TANF, and/or CHIP populations.
Knowledge ofmunity health and social service agencies and additionalmunity resources
Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish
Work-At-Home Requirements
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 required.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
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.
Additional Information
Section 1121 of the Louisiana Code of Governmental Ethics states that current or former agency heads or elected officials, board ormission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH’s Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration.

For more information please visit:

Louisiana Board of Ethics (la.gov)
Interview Format
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.
SSN Alert
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humanamyworkday with instructions on how to add the information into your official application on Humana’s secure website.

Travel:

While this is a remote position, occasional travel to Humana’s offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
Thepensation 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. This incentive opportunity is based uponpany and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offerspetitive 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,pany and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (

NYSE:

HUM) ismitted to putting health first – for our teammates, our customers and ourpany. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, andmunities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms ofpensation and selection for training, including apprenticeship, at all levels of employment.
Request an Amodation
If you are an individual with a disability and require a reasonable amodation toplete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for ing, you may contact ADAhumana for assistance.
Employment Fraud Notice
Humana will never ask a candidate for money for work equipment and network access or request access to personal accounts during the application process. Learn more about identifying and preventing employment fraud or report a suspected employment fraud case.
California Resident Applicants
If you are a California resident ing for a position and would like to review our California Applicant Privacy Policy, click : CA Resident Applicant Privacy Policy
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