Queue Management - Remote

Conviva Senior Primary Care; Kansas; Remote; USD 40,000 - 53,000; Full time

Job summary

A leading healthcare company is seeking a Queue Management Coordinator to support non-clinical operations. This remote role involves managing referral and authorization processes while ensuring compliance with company policies. Ideal candidates will possess strong communication skills and healthcare administrative experience, along with a passion for improving consumer experiences.

Benefits

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Life insurance

Promotions for professional growth

Qualifications

• 1 or more years healthcare administrative or technical support experience.
• Must have accessibility to high speed DSL or Cable modem for a home office.
• Proficient utilizing electronic medical record and documentation programs.

Responsibilities

• Provides non-clinical support for referral/authorization queue management.
• Processes incoming Referrals/Authorizations based on Humana Prior Auth List.
• Assist clinical staff with requesting medical records by phone/fax/EMR.

Skills

Excellent verbal and written communication skills

Working knowledge of MS Office

Healthcare administrative support experience

Education

Bachelor's Degree in Business, Finance or a related field

Tools

Electronic medical record programs

Job description

Join to apply for the Queue Management - Remote role at Conviva Senior Primary Care

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Join to apply for the Queue Management - Remote role at Conviva Senior Primary Care

Conviva Senior Primary Care provided pay range

This range is provided by Conviva Senior Primary Care. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$40,000.00/yr - $52,300.00/yr

Become a part of our caring community and help us put health first

The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

The UM Administration Coordinator - Queue Management provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion. Focus: Referral/Authorization queue management. Process incoming Referrals /Authorizations based on the Humana Prior Auth List and Internal Processes. Assist clinical staff with requesting medical records by phone/fax/EMR.

Required Qualifications

Use your skills to make an impact

• 1 or more years healthcare administrative or technical support experience
• Current or past HMO Experience
• Excellent verbal and written communication skills
• Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
• Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  
  

Preferred Qualifications

• Proficient utilizing electronic medical record and documentation programs
• Proficient and/or experience with medical terminology and/or ICD-10 codes
• Bachelor's Degree in Business, Finance or a related field
• Prior member service or customer service telephone experience desired
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
  
  

Additional Information

For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are ahealthcarecompany committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If Progressed To Offer, You Will Be Required To

• Provide proof of full vaccinationor commit to testing protocols OR
• Provide proof of applicable exemption including any required supporting documentation
  
  

Medical, religious, state and remote-only work exemptions are available.

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire interview. In this interview, you will read to a set of interview questions and you will enter/text responses to each question. You should anticipate this interview to take about 10 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from [e-mail] with instructions to add the information into the application at Humana’s secure website.

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

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.

$40,000 - $52,300 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva’s innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health – addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.

About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

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.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Hospitals and Health Care

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