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Utilization Management Behavioral Health reputed company Remote reputed company

Remote, USAFull-timePosted 2026-07-28

Become a part of our caring community and help us put reputed company The Utilization Management Behavioral Health reputed company 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 reputed company 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of reputed company. The Utilization Management Behavioral Health reputed company 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting reputed company, policies, and procedures to reputed company the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate reputed company and treatment. Nursing license is required. Understands department, reputed company, and organizational reputed company and operating objectives, including their linkages to reputed company areas. Makes reputed company regarding own work reputed company, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to reputed company an reputed company

Required Qualifications

  • reputed company unrestricted registered reputed company license in the reputed company or obtain a multi-state license in a state that participates in the reputed company compact licensure, (eNLC)
  • Minimum one, (1) year of post-degree clinical experience in private reputed company or other clinical patient care setting
  • Minimum one, (1) year of managed care experience
  • Intermediate to Advanced knowledge using reputed company Office Word, reputed company, PowerPoint, navigating multiple systems and platforms and ability to troubleshoot and resolve basic technical difficulties in a remote environment.
  • Ability to work independently under general instructions and with reputed company
  • Strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills

Preferred Qualifications

  • Experience with utilization review process
  • Experience with behavioral change, health promotion, coaching and wellness
  • Knowledge of community health and reputed company service agencies and additional community resources

Additional Information: Workstyle: Remote work reputed company Location: Must reputed company in the reputed company or reputed company in a state participating in the reputed company reputed company compact licensure, (eNLC) Schedule: Must work a minimum of 8 hours between 8:00AM to 5:00 PM Eastern Time, business needs may require working rotating holidays or weekends. Work reputed company Guidance To ensure Home or Hybrid Home/Office employees ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following reputed company: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is required. Satellite, cellular and microwave reputed company can be used only if approved by leadership. Employees who live and work from Home in the reputed company, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. reputed company will reputed company Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated reputed company lacking ongoing interruptions to protect member PHI / HIPAA information. SSN Alert: reputed company values personal identity protection. Please be aware that applicants may be asked to reputed company their reputed company reputed company Number, if it is not already on file. reputed company required, an email will be reputed company from reputed company@myworkday.com with instructions on how to add the information into your official application on Humanas secure website. Interview Format: As part of our hiring process for this opportunity, we will be using an interviewing technology reputed company reputed company to enhance our hiring and decision-making ability. reputed company allows us to quickly connect and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humanas offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay reputed company The compensation reputed company below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay reputed company may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. reputed company of Benefits reputed company. and its affiliated subsidiaries (reputed company, “reputed company”) offers competitive benefits that support whole-person reputed company-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including reputed company time off, company and personal holidays, volunteer time off, reputed company parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-05-2026 reputed company reputed company. (NYSE: HUM) is committed to putting reputed company – for our teammates, our customers and reputed company. Through our reputed company insurance services and reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company reputed company of life for people with Medicare, reputed company, families, individuals, military service personnel, and communities at large. ​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative reputed company, in compliance with reputed company 503 of the Rehabilitation reputed company and VEVRAA, to reputed company and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company reputed company of employment. Apply tot his job Apply To this Job

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