Remote UM Compliance Coordinator III – Data & Audits

Humana Inc; Austin (TX); À distance; USD 45 000 - 60 000; Plein temps

Résumé du poste

Humana Inc. is seeking a Compliance (UM) Coordinator 3 to review utilization management activities and ensure policy adherence.

The role involves data analysis, independent judgment, and interpreting guidelines for expedited requests, often within a three-day, 12-hour shift schedule across Friday to Monday. Ideal candidates have 1–3 years of technical experience, proficiency in Word/Excel, and strong communication skills, with a healthcare clerical background.

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 for policy adherence.
• Collects and analyzes data to assess outcomes and metrics for the team.
• Follows guidelines and regulatory turnaround times for QIO fast track appeals and expedited authorizations.

Connaissances

Technical experience

MS Word

MS Excel

Attention to detail

Communication skills

Healthcare clerical

Formation

Associates' or Bachelor's degree in Healthcare/Business/Finance

Description du poste

Humana Inc. is seeking a Compliance (UM) Coordinator 3 to review utilization management activities and ensure policy adherence.

The role involves data analysis, independent judgment, and interpreting guidelines for expedited requests, often within a three-day, 12-hour shift schedule across Friday to Monday. Ideal candidates have 1–3 years of technical experience, proficiency in Word/Excel, and strong communication skills, with a healthcare clerical background.