Utilization Management Behavioral Health Professional

Become a part of our caring community The Utilization Management Behavioral Health Professional uses behavioral health knowledge to support the coordination, documentation, and communication of medical services and benefit administration determinations. Reporting to the UMB Manager, the UMB Health Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Utilization Management Behavioral Health Professional: u00b7 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 u00b7 Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment u00b7 Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas u00b7 Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed u00b7 Follows established guidelines/procedures u00b7 Occasional travel is required to our corporate office, located in Louisville, Kentucky, based on business need u00b7 Work schedule will be 8:30am-5:00 and includes a weekend rotation, with possibility of alternate schedule to include Sat/Sun hours Use your skills to make an impact Required Qualifications u00b7 3+ years of post-degree clinical experience in private practice or other healthcare settings Must have one of the following active licenses in the state of Kentucky without restriction: u00b7 Registered Nurse u00b7 Licensed Masters Clinical Social Worker (LCSW) u00b7 Licensed Marriage and Family Therapist (LMFT) u00b7 Licensed Professional Counselor (LPC) u00b7 Psychologist (PhD) Preferred Qualifications u00b7 Experience with utilization review process u00b7 Experience with behavioral change, health promotion, coaching and wellness u00b7 Knowledge of community health and social service agencies and additional community resources Additional Information: Remote Nationwide Interview Format As part of our hiring process for this opportunity, we will use an interviewing technology called HireVue to enhance our hiring. HireVue allows us to quickly connect and gain valuable information from you about your relevant experience at a time that is best for your schedule . Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $65,000 - $88,600 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, u201cHumanau201d) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities. Application Deadline: 04-17-2026 About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health u2013 delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer and . u200b Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all 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 all levels of employment.Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our

Created: 2026-04-13