Remote UM Compliance Coordinator - Data-Driven

Humana Inc

Madison (WI)

Remote

USD 45,000 - 60,000

Full time

6 days ago

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Job summary

Humana Inc. is seeking a Compliance (UM) Coordinator 3 to review utilization management activities and documentation for adherence to policies, procedures and regulations. The role involves data collection/analysis to assess outcomes and operational metrics and requires independent judgment in a dynamic environment.

The position follows a four-day, 10-hour shift schedule (Wednesday-Sunday or Thursday-Sunday) with hours between 8:00 a.m. and 8:00 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 policy/compliance adherence.
Collects and analyzes data to assess outcome and operational metrics.
Makes decisions with minimal direction, using guidelines and independent judgment.
Follows regulatory turnaround times and procedures for QIO fast track appeals and expedited authorizations.