Job added in hotlist
Applied job
Contract job
90-day-old-job
part-time-job
Recruiter job
Employer job
Expanded search
Apply online not available
View more jobs in Albany, NY
View more jobs in New York

Job Details

Utilization Management Behavioral Health Professional 2

Company name
Humana Inc.

Location
Albany, NY, United States

Employment Type
Full-Time

Industry
Healthcare

Posted on
Jun 11, 2021

Apply for this job






Profile

Description

The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Utilization Management Behavioral Health Professional 2 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. Other duties as assigned to the role.

Required Qualifications

Master's degree

Must possess a Current, Valid License in State of residence : Licensed Masters Clinical Social Worker (LCSW), Licensed Masters Social Worker (LMSW-ACP), Licensed Professional Counselor (LPC), Psychologist (PhD), Bachelor's or Master's level Registered Nurse (RN) or other professional license

Health professional with at least 3 plus years of clinical experience in a medical facility or office setting or other patient care settings

Experience with Utilization Review and/or Utilization Management

Comprehensive knowledge of Microsoft Office Suite to include Word and Excel

Ability to work an 8-hour shift, Monday through Friday 9:00am to 6:00pm Central Standard Time

Our Department of Defense Contract requires U.S. citizenship for this position

Successfully receive approval for government security clearance (eQIP - Electronic Questionnaire for Investigation Processing)

Work at Home Requirements

Must provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required

A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Preferred Qualifications

Experience with TRICARE contracts and/or the military health care delivery system

Knowledge of ICD-10 codes

Experience with Medical necessity criteria application such as MCG and/or InterQual Criteria

Knowledge of TRICARE policies and programs

Additional Information

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com

Similar Jobs:
Description Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical...
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we...
Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we...
EmploymentCrossing is great because it brings all of the jobs to one site. You don't have to go all over the place to find jobs.
Kim Bennett - Iowa,
  • All we do is research jobs.
  • Our team of researchers, programmers, and analysts find you jobs from over 1,000 career pages and other sources
  • Our members get more interviews and jobs than people who use "public job boards"
Shoot for the moon. Even if you miss it, you will land among the stars.
HealthcareCrossing - #1 Job Aggregation and Private Job-Opening Research Service — The Most Quality Jobs Anywhere
HealthcareCrossing is the first job consolidation service in the employment industry to seek to include every job that exists in the world.
Copyright © 2024 HealthcareCrossing - All rights reserved. 168 192