Behavioral Health Professional

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

📋 Description

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

• Interpret criteria, policies, and procedures related to behavioral health.

• Make independent decisions regarding appropriate actions in diverse and sometimes unclear situations.

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

• Utilize clinical knowledge, communication skills, and critical thinking to deliver suitable treatment, care, or services.

• Adhere to established guidelines and procedures.

• Work typically from Monday to Friday, 8:00 AM to 5:00 PM Eastern Time.

• Occasionally travel to Humana offices for training or meetings as required by business needs.

⛳️ Requirements

• Active state professional licensure in the relevant field without any disciplinary actions or restrictions, such as LCSW, LMSW-ACP, LPC, Psychologist (PhD), or another professional credential.

• A minimum of 3 years of post-degree clinical experience in private practice or similar patient care roles.

• At least 1 year of experience in managed care or health plans.

• Preferred experience with pre-authorization and utilization review processes.

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

• Experience working with populations ranging from pediatric to older adults is preferred.

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

• Bilingual skills in English and Spanish are preferred, including proficiency in speaking, reading, writing, interpreting, and explaining documents in Spanish.

• Must possess an active professional license with no disciplinary actions or restrictions.

• A minimum internet speed of 25 Mbps download and 10 Mbps upload is required.

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

🏝️ 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 holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.