Humana · 9 hours ago

Applied Behavioral Analysis Utilization Management Professional

Remote Florida

Full-time

Remote

Entry, Mid Level

$63K/yr - $87K/yr

2+ years exp

Maximize your interview chances

Health CareHealth Insurance

Insider Connection @Humana

Discover valuable connections within the company who might provide insights and potential referrals.
Get 3x more responses when you reach out via email instead of LinkedIn.

Responsibilities

Utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations.

Work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members.

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

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Board-Certified Behavioral AnalystLicensed Masters Clinical Social WorkerLicensed Professional CounselorApplied Behavioral AnalysisUtilization ManagementMS OfficeCommunity Health KnowledgeSocial Service Agencies KnowledgeManaged Care Experience

Required

Must meet one of the following: Master’s degree AND Board-Certified Behavioral Analyst

Master's degree in a behavioral-health field, such as social work, psychology, or counseling from an accredited university AND Licensed Masters Clinical Social Worker (LCSW), Licensed Masters Social Worker (LMSW-ACP), Licensed Professional Counselor (LPC), Psychologist (PhD), Licensed Marriage Family Therapist, (LMFT)

Active Registered Nurse (RN) license in the state of Florida or enhanced nurse compact license, (eNLC) without disciplinary actions

or other professional license in the state of Florida.

Must meet all of the following: Minimum 2 years of Applied Behavioral Analysis clinical experience

Minimum 2 years utilization management Applied Behavioral Analysis reviewing services

Excellent verbal and written communication skills

Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems and ability to troubleshoot and resolve basic technical difficulties in a remote environment.