Utilization Management Behavioral Health Professional
Humana —Ohio
- $65,000 - $88,600 a year
- Full-time
- LMFT
- Nursing
- Microsoft Excel
- Paid parental leave
- Paid holidays
4d
Appeals Nurse Consultant (Remote)
CVS Health —Columbus, OH
- $60,522 - $129,615 a year
- Weekends as needed
- Remote
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
1d
UR Coordinator, Full Time
RiverVista Behavioral Hospital —Columbus, OH
- $24 - $32 an hour
- Full-time
- Nursing
- Adults
- HIPAA
- Paid holidays
- Disability insurance
Quick Apply
Clinical Informaticist
OhioHealth —Columbus, OH
- Full-time
- Nursing
- Microsoft Excel
- RN License
Utilization Management Specialist
ST VINCENT FAMILY SERVICES —Columbus, OH
- Weekends as needed
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- HIPAA
- Paid time off
- 401(k) matching
Quick Apply
1d
Specialist, Utilization Review
Columbus Springs East —Columbus, OH
- Full-time
- CPR Certification
- Management
- BLS Certification
- Disability insurance
- Health insurance
Quick Apply
Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1)
State of Ohio - Medicaid —Columbus, OH
- $40.40 an hour
- Full-time
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
6d
Denials RN Coordinator
Ensemble RCM LLC —Columbus, OH
- $62,500 - $79,800 a year
- Full-time
- Nursing
- RN License
- 5 years
- Tuition reimbursement
QA Specialist (PRE-ID)
Summit Home Care & Hospice —Columbus, OH
- $28 - $33 an hour
- CPR Certification
- RN License
- Computer literacy
Quick Apply
1d
Director of Rehabilitation
Heritage Rehab —Columbus, OH
- Full-time
- Background check
- Skilled nursing facility
- Physical & Rehabilitation Medicine
- Health insurance
- Dental insurance
Quick Apply
LPN - 1st Shift
The Buckeye Ranch —Grove City, OH
- $23.82 - $30.00 an hour
- Full-time
- Background check
- Nursing
- Vital signs
- Disability insurance
- Health insurance
Quick Apply
RN, LSW, LISW, Care Manager - Columbus
Careforth —Columbus, OH
- $62,657 - $84,173 a year
- Full-time
- Hybrid work
- RN License
- Experience working with individuals with disabilities
- Mid-level
- Wellness program
- Flexible schedule
Manager of Educational Services
MedFlight —Columbus, OH
- From $70,000 a year
- Full-time
- Nursing
- RN License
- PALS Certification
Quick Apply
RN Case Manager
Sheakley —Columbus, OH
- Full-time
- RN License
- Mid-level
- Organizational skills
Quick Apply
3d
CRES Coordinator
Syneos - Clinical and Corporate - Prod —Westerville, OH
- $40,900 - $69,500 a year
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Employee stock purchase plan
- Health insurance
OhioRISE CME Care Coordinator Supervisor I
THE VILLAGE NETWORK —Columbus, OH
- Full-time
- Experience working with individuals with developmental disabilities
- Computer literacy
- HIPAA
- Paid holidays
- Paid time off
Epic Tapestry Certified - Utilization Management - Senior Consultant
Accenture —Columbus, OH
- $68,300 - $201,300 a year
- Full-time
- Hybrid work
- 5 years
- Office
- US work authorization
- Paid holidays
- Disability insurance
Family Preservation Clinical Supervisor
Mentor Behavioral Health —Columbus, OH
- $75,000 a year
- Full-time
- Outpatient experience
- Master's degree
- Children
14d
Outpatient Navigator
Mount Carmel Behavioral Health —Columbus, OH
- Full-time
- LMFT
- Psychiatry
- Hospital
14d
Customer Success Utilization Manager
KARL STORZ —Columbus, OH
- $82,400 - $107,100 a year
- Email
- Laboratory
- Clean driving record
- Up to 50% travel
- Wellness program
- Health savings account

I want to receive the latest job alert for clinical documentation & utilization review in columbus

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

clinical documentation & utilization review jobs near columbus

Care Manager jobs in Columbus, OH

Utility Manager jobs in Columbus, OH

Management Consultant jobs in Columbus, OH

Registered Nurse Case Manager jobs in Columbus, OH

Customer Success Manager jobs in Columbus, OH

Navigator jobs in Columbus, OH

Nurse Coordinator jobs in Columbus, OH

Nurse Consultant jobs in Columbus, OH

Director Of Rehabilitation jobs in Columbus, OH

Systems Administrator jobs in Columbus, OH

Educator jobs in Columbus, OH

Utilization Review Nurse jobs in Columbus, OH

Quality Assurance Specialist jobs in Columbus, OH

Remote Patient Care Coordinator Jobs jobs in Phoenix, AZ

Foster Care Supervisor jobs in Taunton, MA

Security Supervisor jobs in Austin, TX

Foster Care Supervisor jobs in Chicago, IL

Fleet Supervisor jobs in New Jersey

Foster Care Supervisor jobs in St. Louis, MO

Child Care jobs in Casa Grande, AZ

Utilization Management Behavioral Health Professional

Humana -
Ohio

Apply Now

Job Details

Full-time
$65,000 - $88,600 a year
4 days ago

Benefits

Paid parental leave
Caregiver leave
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Parental leave
Vision insurance
Life insurance

Qualifications

Microsoft Excel
Microsoft Outlook
Word embeddings
Microsoft Teams

Full Job Description

Become a part of our caring community

Humana Healthy Horizons in Kentucky is looking for a Utilization Management Behavioral Health Professional 2 who uses 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.

Utilize 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.
Follows established guidelines/procedures.

Use your skills to make an impact

Required Qualifications

Must reside in the state of Kentucky or a county that is contiguous to Kentucky state border in Ohio, Indiana, Illinois, Missouri, Tennessee, Virginia, or West Virginia.
Bachelor's degree in nursing OR a master's degree in a Human Services field with a professional individual or compact licensure in the state of Kentucky without disciplinary action. Such licenses are: Licensed Masters Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Counselor (LPC), Psychologist (PhD), Registered Nurse (RN) or other professional license.
Three (3) or more years of post-degree clinical experience in private practice or other healthcare settings.
Intermediate working knowledge using Microsoft Office Programs specifically Teams, Excel, PowerPoint, Outlook and Word, systems and platforms

Preferred Qualifications

Experience with utilization review process.
Experience with behavioral change, health promotion, coaching and wellness.
Knowledge of community health and social service agencies and additional community resources.
Knowledge and experience working with individuals with substance use diagnoses.
Knowledge of substance use disorders and recovery process.

Additional Information

Workstyle: This is a remote position.
Workdays & Hours: Monday - Friday; 8:30 AM - 5:00 PM Eastern Standard Time (EST).
Travel: Travel is required to our Annual All Hands meeting occurring once per year, typically in the spring. However, this may be subject to change based on business needs.

Work at Home Requirements: 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 criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

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, “Humana”) 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

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 – 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 at Humana.com and at CenterWell.com.

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.

Apply Now

Refine Your Search

clinical documentation & utilization review jobs in columbus

Utilization Management Behavioral Health Professional

Appeals Nurse Consultant (Remote)

UR Coordinator, Full Time

Clinical Informaticist

Utilization Management Specialist

Specialist, Utilization Review

Clinical Review Nurse Supervisor (Medicaid Health Systems Administrator 1)

Denials RN Coordinator

QA Specialist (PRE-ID)

Director of Rehabilitation

LPN - 1st Shift

RN, LSW, LISW, Care Manager - Columbus

Manager of Educational Services

RN Case Manager

CRES Coordinator

OhioRISE CME Care Coordinator Supervisor I

Epic Tapestry Certified - Utilization Management - Senior Consultant

Family Preservation Clinical Supervisor

Outpatient Navigator

Customer Success Utilization Manager

I want to receive the latest job alert for clinical documentation & utilization review in columbus

Related Searches

Explore jobs in more locations

Become a part of our caring community

Use your skills to make an impact

About us

Job Seeker Tools

Employer Tools

Browse

Stay Connected