Remote UM Compliance Coordinator 3 - 3-Day Week Role

Humana Inc; Montpelier (VT); Remote; USD 45,000 - 60,000; Full time

Job summary

Humana Inc. is seeking a Compliance (UM) Coordinator 3 in a remote-capable role to oversee utilization management activities and related documentation. The position involves data collection and analysis, decision-making with limited guidance, and adherence to established guidelines for expedited requests and QIO appeals.

The role supports a three-day, 12-hour shift pattern within a Friday to Monday week, with shifts between 8:00 a.m. and 9:00 p.m.

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 adherence to policies, procedures, and regulations.
• Collects and analyzes data to assess outcome and operational metrics.
• Makes decisions with minimal direction and applies guidelines to determine appropriate courses of action.
• Follows guidelines and timelines for processing QIO fast track appeals and expedited authorization requests.

Skills

Attention to detail

Communication skills

Independent work

Agile environment

Clerical support

Education

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

Tools

Microsoft Word

Microsoft Excel

Job description

Humana Inc. is seeking a Compliance (UM) Coordinator 3 in a remote-capable role to oversee utilization management activities and related documentation. The position involves data collection and analysis, decision-making with limited guidance, and adherence to established guidelines for expedited requests and QIO appeals.

The role supports a three-day, 12-hour shift pattern within a Friday to Monday week, with shifts between 8:00 a.m. and 9:00 p.m.