Remote Compliance UM Coordinator - 4-Day Week

Humana Inc; Des Moines (IA); Remote; USD 45,000 - 60,000; Full time

Benefits offered by this job

Remote work

Flexible schedule

Occasional travel

Job summary

Humana Inc. is seeking a Compliance (UM) Coordinator 3 to review utilization management activities and ensure adherence to policies, procedures, and regulations.

This remote role collects and analyzes data daily to monitor outcomes, requiring independent judgment, strong attention to detail, and excellent communication to support member care.

Schedule is four 10-hour shifts (Wed-Sat or Thu-Sun) within EST, with 8:00 a.m.–8:00 p.m. ET, and occasional overtime or travel as needed.

Qualifications

• 1 - 3 years of technical experience.
• Proficient in Word & Excel.
• Strong attention to detail and accuracy.
• Passion for improving consumer experiences in healthcare.
• Excellent verbal and written communication skills.
• Clerical support in a healthcare environment.
• Ability to work independently in an agile environment.

Responsibilities

• Review utilization management activities for adherence to policies and regulations.
• Analyze data daily to monitor outcomes and inform decisions.
• Interpret guidelines to determine appropriate actions in ambiguous situations.
• Follow regulatory turnaround times and processing guidelines for QIO fast track appeals and expedited authorizations.

Skills

Technical experience

MS Word

MS Excel

Attention to detail

Communication skills

Healthcare clerical

Independent in agile environment

Job description

Humana Inc. is seeking a Compliance (UM) Coordinator 3 to review utilization management activities and ensure adherence to policies, procedures, and regulations.

This remote role collects and analyzes data daily to monitor outcomes, requiring independent judgment, strong attention to detail, and excellent communication to support member care.

Schedule is four 10-hour shifts (Wed-Sat or Thu-Sun) within EST, with 8:00 a.m.–8:00 p.m. ET, and occasional overtime or travel as needed.