Remote UM Compliance Coordinator - 3-Day Week

Humana Inc; Honolulu (HI); 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 documentation, ensuring adherence to policies and regulations. The role involves interpreting guidelines, analyzing data, and making independent decisions with minimal direction.

This remote position follows a three-day, 12-hour shift pattern within a Friday to Monday work week, with hours between 8:00 a.m. and 9:00 p.m. ET.

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 policy adherence.
• Collects and analyzes data to assess outcomes and metrics.
• Makes independent judgments guided by guidelines and timelines.
• Follows guidelines for processing QIO fast track appeals and expedited requests.

Skills

Technical experience

MS Word

MS Excel

Attention to detail

Communication skills

Healthcare clerical

Independent in agile env

Education

Associates or 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, analyzing data, and making independent decisions with minimal direction.

This remote position follows a three-day, 12-hour shift pattern within a Friday to Monday work week, with hours between 8:00 a.m. and 9:00 p.m. ET.