Utilization Management Behavioral Health Nurse 2-Remote Position
Company: Humana
Location: Green Bay
Posted on: May 16, 2022
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Job Description:
**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 7-6:30pm
CST. Hours for this role are based on business need between that
timeframe.
+ **Minimum of Associate'ss 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 Process**
As part of our hiring process, we will be using an exciting
interviewing technology provided by Modern Hire, a third-party
vendor. This technology provides our team of recruiters and hiring
managers an enhanced method for decision-making.
If you are selected to move forward from your application
prescreen, you will receive correspondence inviting you to
participate in a pre-recorded Voice Interview and/or an SMS Text
Messaging interview. If participating in a pre-recorded interview,
you will respond to a set of interview questions via your phone.
You should anticipate this interview to take approximately 10-15
minutes.
If participating in a SMS Text interview, you will be asked a
series of questions to which you will be using your cell phone or
computer to answer the questions provided. Expect this type of
interview to last anywhere from 5-10 minutes. Your recorded
interview(s) via text and/or pre-recorded voice will be reviewed
and you will subsequently be informed if you will be moving forward
to next round of interviews.
**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 Humana@myworkday.com 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
Keywords: Humana, Green Bay , Utilization Management Behavioral Health Nurse 2-Remote Position, Healthcare , Green Bay, Wisconsin
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