RN - UM Behavioral Health-Remote Position

Profile

Description

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

Responsibilities

The Utilization Management Behavioral Health Nurse 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. Nursing license is required. 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.

Required Qualifications

NOTE: Our department is available Monday - Friday from 7-6:30 PM CST. Hours for this role are based on business need between that timeframe.


Minimum of Associate's Degree in Nursing
Registered nurse with Compact Licensure (licensed and located in compact state)
Minimum of three (3) years of post-degree clinical experience in direct patient care
Three (3) years or more of Behavioral Health experience
Minimum of two (2) years of utilization management experience
One (1) year of managed care experience
Proficiency with Microsoft Office products: Word, Excel and MS Teams and OneNote
Adept experience working with computers


Work-At-Home Requirements


WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information


Preferred Qualifications


BSN degree
Master's degree in nursing
Use of EMR systems
Additional Non-compact nursing licenses
Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish


Additional Information

Interview Format:

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected, you will receive correspondence inviting you to participate in a Modern Hire assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 15 - 20 minutes. Your answers will be reviewed and you will subsequently be informed if you will be moving forward to next round.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from **** with instructions to add the information into the application at Humana's secure website.

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field. Every associate and contractor who work inside a Humana facility or in the field, regardless of vaccination status, must complete a daily health screening questionnaire.

Scheduled Weekly Hours

40

Company info

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