Remote UM Compliance Coordinator 3 - Data & Audits

Humana; Denver (CO); À distance; USD 45 000 - 60 000; Plein temps

Avantages offerts par ce poste

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Disability and life insurance

Language interpreter services

Résumé du poste

Humana is hiring a Compliance (UM) Coordinator 3 to join a team that reviews utilization management activities and ensures adherence to policies and regulations. The role involves data analysis and independent judgment within a three-day, 12-hour shift schedule across Friday–Monday.

Responsibilities include handling QIO fast track appeals and expedited authorizations while maintaining accuracy, attention to detail, and strong communication.

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.

Responsabilités

• Reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations.
• 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, and requires minimal direction.
• Follows guidelines and procedures for processing QIO fast track appeals and expedited authorization requests.

Connaissances

Microsoft Word

Microsoft Excel

Attention to detail

Written and verbal communication

Independent work in agile environment

Clerical healthcare experience

Formation

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

Outils

MS Word

MS Excel

Description du poste

Humana is hiring a Compliance (UM) Coordinator 3 to join a team that reviews utilization management activities and ensures adherence to policies and regulations. The role involves data analysis and independent judgment within a three-day, 12-hour shift schedule across Friday–Monday.

Responsibilities include handling QIO fast track appeals and expedited authorizations while maintaining accuracy, attention to detail, and strong communication.