Remote UM Compliance Coordinator 3

Humana Inc; Juneau (AK); Remote; USD 45,000 - 60,000; Full time

Benefits offered by this job

Medical benefits

401(k) retirement plan

Paid time off

Parental leave

Job summary

Humana Inc is seeking a Compliance (UM) Coordinator 3 to review utilization management activities and documentation, ensuring adherence to policies and regulations. The role involves interpreting guidelines and making independent determinations in a fast-paced environment.

The position operates on a three-day, 12-hour shift schedule (Friday-Sunday or Sunday-Monday) within EST, with work hours between 8:00 a.m. and 9:00 p.m. Eastern Time. Travel to Humana offices may be required occasionally.

Qualifications

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

Responsibilities

• Review utilization management activities and documentation to ensure adherence to policies, procedures, and regulations.
• Interpret guidelines and determine appropriate course of action in ambiguous situations.
• Follows guidelines and regulatory turnaround times for processing QIO fast track appeals and expedited authorization requests.

Skills

Tech experience

MS Word/Excel

Attention to detail

Communication

Healthcare clerical

Independent worker

Education

Associates/Bachelor's degree

Job description

Humana Inc is seeking a Compliance (UM) Coordinator 3 to review utilization management activities and documentation, ensuring adherence to policies and regulations. The role involves interpreting guidelines and making independent determinations in a fast-paced environment.

The position operates on a three-day, 12-hour shift schedule (Friday-Sunday or Sunday-Monday) within EST, with work hours between 8:00 a.m. and 9:00 p.m. Eastern Time. Travel to Humana offices may be required occasionally.