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Manager, UM Behavioral Health

Company: Humana
Location: Honolulu
Posted on: June 24, 2020

Job Description:

Description The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals. Responsibilities The Manager, Utilization Management Behavioral Health 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. Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving own departmental area. Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department. Required Qualifications + Degree in nursing or a Master's degree in a behavioral health related field such as social work, counseling, and/or psychology, from an accredited university. + Possess a current, valid, and unrestricted license. Such licenses are: Licensed Masters Social Worker (LMSW, LISW, LCSW or LMSW-ACP), Licensed Professional Counselor (LPC), Licensed Marriage and Family Therapist (LMFT), PhD/EdD, or Registered Nurse (RN). + Minimum of three (3) years of post-degree clinical experience in direct patient care required. + Proficiency with MS office products + Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications + Master's Degree in Business Administration or a related field + Minimum of two (1) years of case management and/or rehabilitative counseling experience required. Certified or certified-eligible case manager required. + 1 year of Utilization Management experience within a hospital setting + Minimum one (1) year of clinical supervisory experience required + Experience with Change Management leadership Additional Information If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. Scheduled Weekly Hours 40 About Us Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms - when and where they need it. Our employees are at the heart of making this happen and that's why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first. Equal Opportunity Employer It is our policy to recruit, hire, train, and promote people without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, or veteran status, except where age, sex, or physical status is a bona fide occupational qualification. View the EEO is the Law poster. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this online application process and need an alternative method for applying, you may contact for assistance. Humana Safety and Security Humana will never ask, nor require a candidate provide money for work equipment and network access during the application process. If you become aware of any instances where you as a candidate are asked to provide information and do not believe it is a legitimate request from Humana or affiliate, please contact to validate the request.

Keywords: Humana, Honolulu , Manager, UM Behavioral Health, Healthcare , Honolulu, Hawaii

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