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Humana is a healthcare and health insurance company focused on improving health outcomes for individuals, communities, and the broader healthcare system. Its work includes Medicare Advantage HMO, PPO, and PFFS plans serving populations such as seniors and military members. Humana also emphasizes an inclusive workplace built around belonging, mutual respect, and opportunities for employees to contribute to the company’s health-focused mission.
Licensed Behavioral Health Utilization Management Clinician – Louisiana Remote
Humana is seeking a licensed behavioral health clinician to support utilization management, medical necessity reviews, and care coordination for Louisiana members. This full-time remote role follows a Sunday–Thursday schedule after weekday training.
Description
- Coordinate, document, and communicate medical service and benefit administration determinations.
- Apply behavioral health criteria, policies, and procedures to evaluate appropriate treatment, care, and services.
- Work with providers, members, and other stakeholders to support effective care and treatment.
- Use clinical expertise, clear communication, and independent critical thinking in daily decisions.
- Determine appropriate work methods in ambiguous situations with limited supervision.
- Adhere to established guidelines, policies, and procedures.
- Attend training Monday through Friday from 8:00 AM to 5:00 PM Central Time.
- After training and precepting, work Sunday through Thursday from 8:00 AM to 5:00 PM Central Time.
- Travel occasionally to Humana offices for training, meetings, or other business needs.
Requirements
- Reside in Louisiana.
- Hold one of the accepted licenses without a history of disciplinary action: a Registered Nurse license under the Multi-State Compact, or a Louisiana professional license supported by a master's degree in a behavioral health-related field.
- Accepted behavioral health licenses include LCSW, LMSW, LPC, LMFT, LAC, and Licensed Psychologist.
- Have at least three years of post-degree clinical experience providing direct patient care.
- Have at least three years of behavioral health experience.
- Use Microsoft Office, navigate multiple systems and platforms, and perform basic technical troubleshooting in a remote setting.
- Be available for an Eastern Time schedule, including occasional weekends and holidays.
- Maintain a dedicated, interruption-free workspace to safeguard PHI and HIPAA-protected information.
- Have home internet service with at least 25 Mbps download and 10 Mbps upload speeds.
Benefits
- Eligibility for a bonus incentive plan tied to company and individual performance.
- Medical, dental, and vision coverage.
- 401(k) retirement savings plan.
- Paid time off.
- Company and personal holidays.
- Paid parental and caregiver leave.
- Short-term and long-term disability coverage.
- Life insurance.
- Remote work arrangement.
- Minimal travel, expected to be less than 5%.
- Internet service requirements and support for eligible home or hybrid home/office employees.
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