Remote Compliance UM Coordinator 3 — 3‑Day Week

Humana Inc; Carson City (NV); Remote; USD 45,000 - 60,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings

Paid time off

Job summary

Humana Inc. is seeking a Compliance (UM) Coordinator 3 to review utilization management activities and ensure adherence to policies and regulations. The role requires independent judgment and the ability to interpret guidelines. This position follows a three-day, 12-hour shift schedule with a Friday to Monday work week, and hours between 8:00 a.m.

and 9:00 p.m. ET. Remote work is possible; occasional travel to Humana offices for training or meetings may be required.

Qualifications

• 1 - 3 years of technical experience.
• Proficient in Microsoft Word & Excel.
• Strong attention to detail and accuracy.
• Passionate about improving consumer experiences.
• Excellent verbal and written communication.
• Clerical support background in healthcare.

Responsibilities

• Reviews utilization management activities and documentation to ensure policy compliance.
• Interprets guidelines and makes independent determinations on action.
• Follows regulatory turnaround times and processes QIO fast track appeals and expedited requests.

Skills

Technical experience

Microsoft Word

Microsoft Excel

Attention to detail

Communication skills

Healthcare clerical support

Independent work in agile environment

Education

Associates' or Bachelor's degree in Healthcare, Business, Finance, or related field

Job description

Humana Inc. is seeking a Compliance (UM) Coordinator 3 to review utilization management activities and ensure adherence to policies and regulations. The role requires independent judgment and the ability to interpret guidelines. This position follows a three-day, 12-hour shift schedule with a Friday to Monday work week, and hours between 8:00 a.m.

and 9:00 p.m. ET. Remote work is possible; occasional travel to Humana offices for training or meetings may be required.