Remote Compliance UM Coordinator III - 3-Day Week

Humana Inc; United States; Remote; USD 45,000 - 60,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

401(k) retirement plan

Paid time off and holidays

Disability insurance

Life insurance

Job summary

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

This role requires independent judgment within established guidelines and a willingness to handle complex, varied assignments. The position supports data collection and analysis across daily, weekly, and monthly metrics, with a fixed EST/ remote schedule and a three-day, 12-hour shift pattern from Friday to Monday and occasional

Qualifications

• 1–3 years of technical experience.
• Proficient in Word and Excel.
• Strong attention to detail and accuracy.
• Excellent verbal and written communication skills.
• Healthcare clerical background.
• Ability to work independently in an agile environment.

Responsibilities

• Review utilization management activities and documentation.
• Collect and analyze data to assess operational metrics.
• Make independent determinations within guidelines.
• Follow guidelines for QIO fast-track appeals and expedited requests.

Skills

Technical experience

Attention to detail

Communication skills

Independent work

Agile environment

Tools

Microsoft Word

Microsoft Excel

Job description

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

This role requires independent judgment within established guidelines and a willingness to handle complex, varied assignments. The position supports data collection and analysis across daily, weekly, and monthly metrics, with a fixed EST/ remote schedule and a three-day, 12-hour shift pattern from Friday to Monday and occasional