Care Management Support Assistant

Humana Inc; Northern (KY); Hybrid; USD 39,000 - 49,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Job summary

Humana Inc. is seeking a Care Management Support Assistant 2 for the Autism Care Demonstration (ACD) Referral Coordinated role. You will process referrals from military treatment facilities and civilian providers, coordinate authorizations, and assist with information gathering to finalize referrals.

Responsibilities include data entry, eligibility reviews, and notifying appropriate queues. You will educate beneficiaries and providers about the TRICARE ACD program and handle inquiries via phone

Qualifications

• 2+ years of medical coding and/or behavioral health experience.
• 3+ years in customer service or referral management role with handling high volume and deadlines.
• 3 years of experience in healthcare/medical or health insurance field.
• US citizenship required due to DoD contract.
• Ability to obtain government security clearance NBIS.
• Puerto Rico work eligibility prohibited under the contract.

Responsibilities

• Process referrals for the ACD program from MTFs and civilian providers.
• Coordinate authorizations with Autism Services Navigators and Utilization Management.
• Answer questions from associates and providers to obtain needed information for referrals.
• Enter data in medical management system and review eligibility.
• Pend tasks to appropriate queues for completion or escalation.
• Answer inbound calls regarding TRICARE ACD program and educate beneficiaries/providers.
• Monitor phone queues and web chats for inquiries.

Skills

Medical coding

Behavioral health

Customer service

Referral management

Healthcare industry

Health insurance

Education

Bachelor's degree

Job description

Become a part of our caring community The Care Management Support Assistant 2 - Autism Care Demonstration (ACD) Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program.

Key Accountabilities

• You will recognize ACD specific assessments/treatment plans and pend referrals and authorizations for review.
• You will coordinate authorizations with Autism Services Navigators and Utilization Management.
• You will answer questions from associates and MTF/ civilian providers to obtain additional information that may complete referrals.
• Data entry into medical management system, eligibility reviews, reviewing for ECHO benefits, non-clinical overview of assessments
• Complete documentation to pend tasks to appropriate queues who can complete or request additional information.
• You will answer inbound calls on the TRICARE Autism Care Demonstration using available resources.
• Educate beneficiaries and providers regarding the TRICARE ACD program.
• You will monitor the phone queues and web chats to answer provider/beneficiary inquiries.
• You will report to a Supervisor of Care Management Support.
• Use your skills to make an impact.

Required Qualifications

• Work a shift of 10:30 a.m. - 7 p.m. E.T. to help handle internal phone queue
• 2 or more years of medical coding and/or behavioral health experience
• 3 or more years of experience in customer service or referral management position (handling high volume of work with a deadline)
• 3 years of experience in healthcare/medical or health insurance field
• Our Department of Defense Contract requires U.S. citizenship for this position
• Successfully receive approval for government security clearance (Via National Background Investigation Services NBIS)
• HGB is not authorized to do work in Puerto Rico per our government contract.
• We are not able to hire candidates that are currently living in Puerto Rico

Preferred Qualifications

• Military health care service experience or working knowledge of TRICARE entitlement program
• Bachelor's degree

Additional Information

Work Days/Hours: Will work an 8-hour shift of 10:30 a.m.-7 p.m. EST, Monday through Friday

Overtime per business need

Training hours: Mandatory for the first 4-6 weeks: 8 a.m.-4:30 p.m. EST

Work Style: Remote Work at Home

Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Florida Background Screening Requirements: Notice for candidates applying to this position from a Florida work location, including Florida home-based work location. This position is subject to Florida Level 2 background screening through the Care Provider Background Screening Clearinghouse. For information about the screening process and requirements, visit: https://info.flclearinghouse.com.

Scheduled Weekly Hours 40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$39,000 - $49,400 per year

Description of Benefits

• Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being.
• Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.
• Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 09-18-2026

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.