Utilization Management Behavioral Health Professional

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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 link...