Manager, Utilization Management (Behavioral Health) - Oklahoma
Company: Humana Inc.
Location: Fort Sill
Posted on: May 3, 2021
The Manager, Utilization Management (Behavioral Health) utilizes
behavioral health knowledge and skills to support the coordination,
documentation, and communication of medical services and/or benefit
administration determinations. The Manager, Utilization Management
(Behavioral Health) works within specific guidelines and
procedures; applies advanced technical knowledge to solve
moderately complex problems; receives assignments in the form of
objectives and determines approach, resources, schedules and
The Manager, Utilization Management (Behavioral Health) uses
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.
- Decisions are typically related to resources, approach, and
tactical operations for projects and initiatives involving own
- An active Licensed Registered Nurse (RN), a licensed Masters
Level Social Worker (LCSW, LMSW, LMSW-ACP, CSW, LPC, LMFT) or a
Psychologist (PhD/EdD) in the State of Oklahoma without
- 3 or more years of post-degree clinical experience in direct
- 2 or more years of case management and/or rehabilitative
- 1 or more years of clinical supervisory experience.
- Comprehensive knowledge of Microsoft Office applications
including Word, Excel, and Outlook.
- This role is considered patient facing and is a part of
Humana's Tuberculosis (TB) screening program. If selected for this
role, you will be required to be screened for TB.
- This role is part of Humana's Driver safety program and
therefore requires an individual to have a valid state driver's
license and proof of personal vehicle liability insurance with at
least 100,000/300,000/100,000 limits.
- Must have a separate room with a locked door that can be used
as a home office, to ensure you have absolute and continuous
privacy while you work.
- Must have the ability to provide a high-speed DSL or cable
modem for a home office (Satellite and Wireless Internet service is
NOT allowed for this role). A minimum standard speed for optimal
performance of 10x1 (10mbs download x 1mbs upload) is
- Must be passionate about contributing to an organization
focused on continuously improving consumer experiences.
- Certified or certified-eligible case manager (CCM)
- Experienced with Milliman or Interqual criteria.
- Benefits: Effective on the 1st day of employment; Medical,
Dental & Vision, Competitive 401k match, Paid Time Off (PTO)
accruals, Tuition Reimbursement, Parental Leave & much
- Direct Reports: Up to 15 associates.
- Typical Days/Hours: Monday - Friday; 8:00am - 5:00pm Central
Standard Time (CST).
- Travel: 25% in the state of Oklahoma to member's homes,
facilities and/or business onsite meetings(Note: Business travel is
suspended at this time due to business travel restrictions).
- Work location: Combination of office, field and remote. Ratio
to be determined by leadership. Work location is temporary remote
full-time - In order to support the CDC recommendations on social
distancing and reduce health risks for associates, members and
public health, Humana is deploying virtual and video technologies
for all hiring activities. This position may be subject to
temporary work at home requirements for an indefinite period of
time. These requirements include: Access to a personal computing
device with a camera, a minimum internet connection speed of 10m x
1m, Dedicated secure home workspace for interview or work purposes.
Humana continues to monitor the situation, and will adjust service
levels as the coronavirus situation evolves. The following changes
are temporary and will be evaluated frequently with the goal of
returning to normal operations as soon as possible. Your Talent
Acquisition representative will advise on the latest
recommendations to protect your health and wellbeing during the
As part of our hiring process, we will be using an exciting
interviewing technology provided by Montage, a third-party vendor.
This technology provides our team of recruiters and hiring managers
an enhanced method for decision-making.
If you are selected to move forward from your application
prescreen, you will receive correspondence inviting you to
participate in a pre-recorded Voice Interview and/or an SMS Text
Messaging interview. If participating in a pre-recorded interview,
you will respond to a set of interview questions via your phone.
You should anticipate this interview to take approximately 10-15
If participating in a SMS Text interview, you will be asked a
series of questions to which you will be using your cell phone to
answer the questions provided. Expect this type of interview to
last anywhere from 5-10 minutes. Your recorded interview(s) via
text and/or pre-recorded voice will be reviewed and you will
subsequently be informed if you will be moving forward to next
round of interviews.
Scheduled Weekly Hours
Keywords: Humana Inc., Lawton , Manager, Utilization Management (Behavioral Health) - Oklahoma, Other , Fort Sill, Oklahoma
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