Humana · 2 days ago
Utilization Management Behavioral Health Professional
United States
Full-time
Remote
Entry, Mid Level
$65K/yr - $89K/yr
1+ years expHumana is committed to putting health first and is seeking a Utilization Management Behavioral Health Professional to support the coordination, documentation, and communication of medical services. This role requires clinical knowledge and skills to facilitate optimal care and treatment for members, while making independent decisions in varied situations.
Health CareHealth InsuranceInsuranceVenture Capital
Responsibilities
Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment
Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas
Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed
Follows established guidelines/procedures
Qualification
Required
Master's level clinician with independent licensure in the state of Louisiana (i.e. Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapists (LMFTs) Licensed Addiction Counselors (LACs)
1+ year of managed care experience
Experience utilizing MCG and American Society of Addiction Medicine Criteria
Intermediate to advanced computer skills and experience with Microsoft Word, Excel and Outlook
Ability to use a variety of electronic information applications/software programs including electronic medical records
Must be available to work 40-hour work week Monday – Friday 8:00-5:00 PM CST, potential for overtime with an expectation to cover a weekend and on-call rotation to meet business needs
Must reside in Louisiana and perform work within the state
Preferred
2 years of direct care experience in an acute or outpatient behavioral health setting
Experience with Utilization Management or Prior Authorization
Experience with behavioral change, health promotion, coaching and wellness
Experience serving Medicare, Medicaid, TANF, and/or CHIP populations
Knowledge of community health and social service agencies and additional community resources
Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish
Benefits
Medical, dental and vision benefits
401(k) retirement savings plan
Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
Short-term and long-term disability
Life insurance
Company
Humana
Humana is a health insurance provider for individuals, families, and businesses.
10001+ employees
H1B Sponsorship
Humana has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (282)
2024 (246)
2023 (284)
2022 (274)
2021 (212)
2020 (84)
Funding
Current Stage
Public CompanyTotal Funding
$13.07B2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B
Leadership Team
Jim Rechtin
CEO and President
Caleb Gallifant
Vice President Of Product
Recent News
2026-01-16
2026-01-16
Company data provided by crunchbase