Humana — жеке тұлғалардың, қауымдастықтардың және жалпы денсаулық сақтау жүйесінің денсаулық нәтижелерін жақсартуға бағытталған денсаулық сақтау және медициналық сақтандыру компаниясы. Оның қызметіне қарттар мен әскери қызметшілер сияқты топтарға арналған Medicare Advantage HMO, PPO және PFFS жоспарлары кіреді. Humana сонымен қатар өзара құрметке, ортақ ортаға және қызметкерлердің компанияның денсаулыққа бағытталған миссиясына үлес қосу мүмкіндігіне негізделген инклюзивті жұмыс ортасын қалыптастыруға мән береді.
Humana Behavioral Health Utilization Management Clinician - Louisiana Remote
Humana seeks a Louisiana-based behavioral health utilization management clinician for a full-time remote role. The position supports clinical reviews, care coordination, and benefit determinations and is open to qualified RNs and licensed behavioral health professionals.
Сипаттама
- Coordinate, document, and communicate medical services and benefit administration determinations
- Interpret behavioral health criteria, policies, and procedures to assess appropriate treatment, care, and services
- Communicate with providers, members, and other stakeholders to support effective care and treatment
- Use clinical expertise, clear communication, and independent critical thinking in daily decisions
- Align work with department, segment, and organizational strategies and operating objectives
- Determine work methods independently when situations are occasionally ambiguous and guidance is limited
- Perform duties in accordance with established guidelines and procedures
- Work remotely, with occasional travel to Humana offices for training or meetings
Талаптар
- Must live in Louisiana
- Hold either a Licensed Registered Nurse credential under the Multi-State Compact or a Louisiana professional license tied to a master's degree in social work, counseling, psychology, or another behavioral health field, with no disciplinary history
- Candidates using the behavioral-health master's-degree pathway must also hold an independent Kentucky license
- Accepted licenses include LCSW, LMSW, LPC, LMFT, LAC, and Licensed Psychologist
- At least three years of post-degree clinical experience providing direct patient care
- At least three years of behavioral health experience
- Working knowledge of Microsoft Office, multiple systems and platforms, and basic remote technical troubleshooting
- Availability Monday through Friday, 8:00 AM to 5:00 PM Central Time, with flexibility for Eastern Time scheduling and occasional weekends and holidays
- Internet connection with minimum speeds of 25 Mbps download and 10 Mbps upload
- Dedicated, interruption-free workspace suitable for protecting member PHI and HIPAA information
- Preferred experience with behavioral health utilization management using MCG, ASAM, or InterQual criteria
- Managed care or Medicaid experience preferred
- Health plan experience preferred
Артықшылықтар
- Eligibility for a bonus incentive plan tied to company and/or 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- and long-term disability coverage
- Life insurance
- Employee-provided internet service for remote work
- Occasional travel to Humana offices for training or meetings