Remote Utilization Management Behavioral Health Nurse 2- (Compact Licensure)

Humana

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Location: Omaha, NE
Location Type: Omaha – Remote
Schedule: Full_time
Req: R-313472

Description

 

This department is available Monday – Friday from 10:00 AM-6:30 PM CST. Hours for this role are based on business need between that timeframe. 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

 

Required Qualifications

  • Minimum of Associate’s Degree in Nursing
  • Registered nurse with active Compact Licensure and no disciplinary actions
  • Minimum 3 years of post-degree Clinical or Behavioral Health experience in direct patient care
  • Adept experience working with computers, including proficiency with Microsoft Office products: Word, Excel and MS Teams and OneNote
  • Must be able to work Monday – Friday from 10:00 AM-6:30 PM CST.

 

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 25×10 (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

  • Advanced nursing degree: BSN or MSN
  • Experience with Behavioral Health utilization management experience, performing medical necessity reviews against criteria such as MCG, ASAM, Interqual, etc.
  • 1 year of managed care experience working directly with insurance companies
  • Use of EMR systems
  • Additional Non-compact nursing licenses
  • Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish

 

 

               

Typically requires Bachelor’s degree or equivalent and less than 5 years of technical experience

 

 

Scheduled Weekly Hours

 

40