Remote UM Compliance Coordinator 3 | 4x10 Schedule

Humana Inc; Lansing (MI); 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. This role requires independent judgment and attention to regulatory turnaround times for QIO fast track appeals and expedited authorizations.

The position follows a 4-day, 10-hour schedule (Wednesday-Saturday or Thursday-Sunday) with shifts between 8:00 a.m. and 8:00 p.m. ET, and offers a remote work arrangement with potential travel to Humana offices as needed.

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 to ensure adherence to policies, procedures, and regulations.
• Follows established guidelines for processing QIO fast track appeals and expedited authorization requests.
• Collects and analyzes data daily, weekly, monthly, or as needed to assess outcome and operational metrics.
• Makes decisions regarding own work methods, occasionally in ambiguous situations, with minimal direction and guidance.

Skills

Technical experience

Attention to detail

Verbal and written communication

Independent & agile work

Healthcare clerical background

Consumer experience focus

MS Word & Excel

Education

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

Tools

Microsoft Word & Excel

Job description

Humana Inc. is seeking a Compliance (UM) Coordinator 3 to review utilization management activities and ensure adherence to policies. This role requires independent judgment and attention to regulatory turnaround times for QIO fast track appeals and expedited authorizations.

The position follows a 4-day, 10-hour schedule (Wednesday-Saturday or Thursday-Sunday) with shifts between 8:00 a.m. and 8:00 p.m. ET, and offers a remote work arrangement with potential travel to Humana offices as needed.