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

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

📋 Description

• Facilitate the coordination, documentation, and communication of medical services and/or benefit administration decisions.

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

• Engage in coordination and communication with providers, members, and other stakeholders to ensure optimal care and treatment.

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

• Comprehend the department, segment, and organizational strategy along with operating objectives.

• Make informed decisions about work methods, including in uncertain situations, with limited guidance.

• Adhere to established guidelines and procedures.

⛳️ Requirements

• Must reside in Oklahoma.

• Hold one of the following licensures with no record of disciplinary action: Licensed Registered Nurse (RN) – Multi-State Compact; or a master’s degree in a behavioral health-related discipline (Social Work, Counseling, Psychology) with a professional license from the state of Oklahoma.

• Acceptable behavioral health 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 various systems and platforms, and possess general technical skills to troubleshoot and resolve issues in a remote setting.

• Flexibility to accommodate Eastern Time hours, including occasional weekends and holidays.

• Required home internet speeds of 25 Mbps download and 10 Mbps upload.

• Capability to work from a designated space free from ongoing interruptions to safeguard member PHI/HIPAA information.

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

• Preferred: Background in Managed Care or Medicaid.

• Preferred: Experience within a health plan.

🏝️ Benefits

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

• Comprehensive 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 insurance.

• Life insurance coverage.

• Occasional travel to Humana offices for training or meetings may be necessary.