Utilization Management Behavioral Health Professional

Humana

. Support coordination, documentation, and communication of medical services and benefit administration determinations .

Posted 9/15/2026full-timeRemote • Louisiana • United StatesJunior💰 $65,000 - $88,600 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in behavioral health coordination and documentation, with a strong focus on communication and compliance with established guidelines. Proficient in utilizing electronic information systems and Microsoft Office tools to support effective treatment and care for members.

Highest-signal resume keywords

Master's Level ClinicianIndependent Licensure (LCSW, LPC, LMFT, LAC)Managed Care ExperienceUtilization Management ExperienceProficiency in Microsoft Office

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Behavioral Health CoordinationNarrative DocumentationElectronic Information Systems ProficiencyKeyboard SkillsWeb Navigation Skills

Soft Skills

Exceptional Communication AbilitiesInterpersonal Skills

Tools & Technologies

Microsoft WordMicrosoft OutlookMicrosoft Excel

Certifications & Qualifications

Independent Licensure in Louisiana

Industry Keywords

MCG CriteriaAmerican Society of Addiction Medicine CriteriaUtilization ManagementPrior AuthorizationCommunity Health AgenciesMedicareMedicaidTANFCHIPPHI/HIPAA Compliance

About the role

Key responsibilities & impact

Support coordination, documentation, and communication of medical services and benefit administration determinations
Interpret criteria, policies, and procedures to determine appropriate treatment, care, or services for members
Coordinate and communicate with providers, members, and other parties to facilitate optimal care and treatment
Follow established guidelines and procedures
Report to the Behavioral Health Manager and participate in the Behavioral Health UM Team
Work Monday through Friday during scheduled hours, with weekend and on-call rotations and potential overtime
Complete a six-week training process
Occasionally travel to Humana offices for training or meetings

Requirements

What you’ll need

Master's level clinician with independent licensure in the state of Louisiana, such as LCSW, LPC, LMFT, or LAC
1+ year of managed care experience
Familiarity with MCG and American Society of Addiction Medicine Criteria
Proficiency using electronic information systems and Microsoft Office tools (Word, Outlook, Excel)
Strong keyboard and web navigation skills
Ability to provide clear narrative documentation
Exceptional communication and interpersonal abilities
Must be available for a 40-hour work week, Monday–Friday, 8:00 AM–5:00 PM CST
Must cover weekend and on-call rotations as needed
Must reside in Louisiana and perform work within the state
Preferred: 2 years of direct care experience in an acute or outpatient behavioral health setting
Preferred: Experience with Utilization Management or Prior Authorization
Preferred: Experience with behavioral change, health promotion, coaching, and wellness
Preferred: Experience serving Medicare, Medicaid, TANF, and/or CHIP populations
Knowledge of community health and social service agencies and additional community resources
Minimum home internet speed of 25 Mbps download and 10 Mbps upload
Must work from a dedicated space protecting member PHI/HIPAA information
Separation of two or more years from LDH is required for covered current or former LDH officials or employees

Benefits

Comp & perks

Bonus incentive plan based on company and/or individual performance
Medical, dental, and vision benefits
401(k) retirement savings plan
Paid time off
Company and personal holidays
Paid parental and caregiver leave
Short-term and long-term disability
Life insurance
Six-week training process
Remote work arrangement
Occasional travel to Humana offices for training or meetings may be required