Care Management Support Assistant

Humana

United States

Remote

USD 39,000 - 49,000

Full time

14 days+

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Job summary

Humana is seeking a Care Management Support Assistant 2 - Autism Care Demonstration Referral Coordinator to process referrals from MTFs and civilian providers for the ACD program.

This remote role requires thorough data entry, referral pendings, and collaboration with Autism Services Navigators. It also includes answering beneficiary and provider inquiries, coordinating with Utilization Management, and maintaining accurate documentation to support the ACD program.

Qualifications

2+ years of medical coding and/or behavioral health experience.
3+ years of experience in customer service or referral management.
3+ years of experience in healthcare/medical or health insurance field.
U.S. citizenship required for DoD contract.

Responsibilities

You will recognize ACD specific assessments/treatment plans and pend referrals and authorizations for review.
Coordinate authorizations with Autism Services Navigators and Utilization Management and respond to questions from associates/providers.
Data entry into medical management system, eligibility reviews, and non-clinical overview of assessments.
Pend tasks to appropriate queues for completion or information requests.
Answer inbound calls on the TRICARE Autism Care Demonstration and educate beneficiaries and providers.
Monitor phone queues and web chats to answer inquiries.
Report to a Supervisor of Care Management Support.

Skills

Medical coding

Behavioral health

Customer service

Referral management

Job description

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

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

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.

Humana is dedicated to providing innovative, personalized healthcare solutions that empower members to achieve their best health in a simplified and compassionate manner.

Company size 10,001+ employees

Company type Public company

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