Licensed Behavioral Health UM, RN, SW, Counseling, Psychology

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

📋 Description

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

• Analyze behavioral health policies, criteria, and procedures to ascertain suitable treatment, care, or services.

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

• Utilize clinical expertise, communication capabilities, and independent critical thinking.

• Comprehend departmental, segment, and organizational strategies and operational objectives.

• Make informed decisions regarding work methodologies in occasionally ambiguous circumstances with minimal supervision.

• Adhere to established guidelines and procedures.

• Work remotely while occasionally traveling to Humana offices for training or meetings.

⛳️ Requirements

• Must be a resident of Louisiana.

• One of the following licensure requirements with no history of disciplinary action: Licensed Registered Nurse (RN) – Multi-State Compact; or a Master's degree in a behavioral health-related field (Social Work, Counseling, Psychology) with a professional license from the state of Louisiana.

• An additional independent Kentucky license is mandatory for the behavioral-health-related master's-degree pathway.

• Eligible licenses include LCSW, LMSW, LPC, LMFT, LAC, or Licensed Psychologist.

• A minimum of 3 years of post-degree clinical experience in direct patient care.

• At least 3 years of experience in Behavioral Health.

• Proficient in MS Office, adept at navigating multiple systems and platforms, and skilled in general technical troubleshooting in a remote setting.

• Availability Monday through Friday, 8:00 AM–5:00 PM Central Time; flexibility for Eastern Time scheduling, occasional weekends, and holidays.

• Minimum internet speed of 25 Mbps download and 10 Mbps upload.

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

• Preferred: Experience in Behavioral Health UM utilizing MCG, ASAM, or InterQual criteria.

• Preferred: Background in Managed Care or Medicaid.

• Preferred: Experience in health plan settings.

🏝️ 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.

• Self-provided internet service for remote work.

• Occasional travel to Humana offices for training or meetings.