Behavioral Health Nurse

This is a fully remote position, open to applicants in United States.

📋 Description

• Assist in the coordination, documentation, and communication of medical services or benefit administration decisions.

• Utilize behavioral health expertise and clinical knowledge to interpret criteria, policies, and procedures.

• Deliver appropriate treatment, care, or services to members.

• Collaborate and communicate with providers, members, and other stakeholders to ensure optimal care and treatment.

• Make independent assessments and decisions regarding work methods and courses of action.

• Adhere to established guidelines and procedures.

• Operate from a designated home workspace while maintaining necessary internet connectivity.

• Occasionally travel to Humana offices for training or meetings.

⛳️ Requirements

• Active Registered Nurse (RN) license in Indiana.

• At least an associate's degree in nursing (ASN) from an accredited institution.

• A minimum of one year of post-degree clinical experience in private practice or other patient care settings.

• At least one year of experience in managed care.

• A strong passion for contributing to an organization committed to enhancing consumer experiences.

• Must reside in the state of Indiana.

• A dedicated workspace free from interruptions to safeguard member PHI / HIPAA information.

• Self-provided internet with a minimum download speed of 25 Mbps and upload speed of 10 Mbps.

• Bachelor of Science in Nursing (BSN) is preferred.

• Bachelor's Degree is preferred.

• Experience with the utilization review process is preferred.

• Previous experience with MCG, ASAM, and medical policy reviews is preferred.

• Experience in behavioral change, health promotion, coaching, and wellness is preferred.

• Experience working with the older adult population is preferred.

• Knowledge of community health and social service agencies, along with additional community resources, is preferred.

• Bilingual in English and Spanish is preferred.

🏝️ Benefits

• Bonus incentive plan based on company and/or individual performance.

• Medical, dental, and vision benefits.

• 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.

• Personal wellness and smart healthcare decision support.

• Occasional travel to Humana offices for training or meetings.