Utilization Management Behavioral Health Professional

Are you passionate about improving the quality of care for individuals with behavioral health needs? Do you excel in utilizing evidence-based practices to ensure effective and efficient treatment? If so, Humana has an exciting opportunity for you as a Utilization Management Behavioral Health Professional.As a member of our team, you will play a crucial role in advocating for the most appropriate and cost-effective care for our members. Your expertise in behavioral health treatment and utilization management will be essential in ensuring our members receive the best possible care.We are seeking candidates with a strong background in behavioral health, including experience in utilization management and a thorough understanding of evidence-based practices. Additionally, strong communication and collaboration skills are a must, as you will work closely with providers and care teams to achieve the best outcomes for our members.Join us at Humana and make a positive impact on the lives of our members while advancing your career in behavioral health.

1. Conduct utilization management activities to ensure appropriate and cost-effective care for members with behavioral health needs.
2. Utilize evidence-based practices to guide decision-making and treatment planning.
3. Advocate for the best interests of members and ensure they receive high-quality care.
4. Collaborate with providers and care teams to develop individualized treatment plans for members.
5. Monitor and track member progress and outcomes, making adjustments to treatment plans as needed.
6. Utilize data and analytics to identify areas for improvement and implement strategies to enhance the quality of care.
7. Stay up-to-date on industry trends and best practices in behavioral health treatment and utilization management.
8. Participate in case reviews and consult with other professionals to ensure comprehensive and effective care for members.
9. Communicate with members, providers, and other stakeholders to address any concerns or questions related to utilization management.
10. Maintain accurate and detailed documentation of all utilization management activities.
11. Adhere to ethical and professional standards of conduct.
12. Act as a resource for colleagues and provide guidance and training on behavioral health treatment and utilization management.
13. Continuously evaluate and improve utilization management processes and procedures to promote efficiency and effectiveness.
14. Collaborate with other departments and teams to ensure coordination of care for members.
15. Represent Humana in a professional and positive manner at all times.

According to JobzMall, the average salary range for a Utilization Management Behavioral Health Professional is $60,000-$80,000 per year. This can vary depending on factors such as location, experience, and employer.

Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. Its strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people they serve across the country. The company operates its business through the following segments: Retail, Group, and Healthcare Services.