Remote Compliance UM Coordinator III (3-Day Week)

Humana Inc; Salem (OR); Remote; USD 45,000 - 60,000; Full time

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 role requires independent judgment, data analysis, and interpretation of guidelines, with focus on QIO fast track appeals and expedited authorizations.

The position is remote with a three-day, 12-hour shift schedule within a Friday to Monday week (8:00 a.m.–9:00 p.m. ET).

Qualifications

• 1 - 3 years of technical experience.
• Proficient in Microsoft Word & Excel.
• Strong attention to detail and accuracy.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
• Excellent verbal and written communication skills.
• Clerical support background in a healthcare environment.
• Ability to work independently in an agile environment under general instructions and within a team.

Responsibilities

• Reviews utilization management activities and documentation for policy and regulatory adherence.
• Collects and analyzes data to assess output and team metrics on various timelines.
• Follows guidelines and procedures for processing QIO fast track appeals and expedited authorizations.

Skills

Word & Excel

Attention to detail

Excellent communication

Healthcare clerical experience

Independent 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, procedures, and regulations. This role requires independent judgment, data analysis, and interpretation of guidelines, with focus on QIO fast track appeals and expedited authorizations.

The position is remote with a three-day, 12-hour shift schedule within a Friday to Monday week (8:00 a.m.–9:00 p.m. ET).