Humana Application – Behavioral Health Nurse

Job 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.

Job Requirements:

• Registered nurse with Compact Licensure (licensed and located in compact state)
• Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish
• Use of EMR systems
• Proficiency with Microsoft Office products: Word, Excel and MS Teams and OneNote
• Additional Non-compact nursing licenses

Qualification & Experience:

• One (1) year of managed care experience working directly with insurance companies
• Master’s degree in nursing
• Three (3) years or more of Behavioral Health experience
• Minimum of three (3) years of post-degree clinical experience in direct patient care
• Minimum of two (2) years of Behavioral Health utilization management experience, performing medical necessity reviews against criteria such as MCG, ASAM, Interqual, etc.
• BSN degree
• Adept experience working with computers
• Minimum of Associate’s Degree in Nursing

Job Details:

Company: Humana

Vacancy Type: Full Time

Job Location: San Antonio, TX, US

Application Deadline: N/A

Apply Here

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