Remote UM Compliance Coordinator III – Data & Audits

Humana Inc; Lincoln (NE); Remote; USD 45,000 - 60,000; Full time

Job summary

Humana Inc invites a Compliance (UM) Coordinator 3 to review utilization management activities and documentation, ensuring compliance with policies and regulations while analyzing data to drive operational success.

This remote role supports a three-day, 12-hour shift schedule (Friday–Monday) with hours between 8:00 a.m. and 9:00 p.m. ET and may require occasional travel for training or meetings.

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 adherence to policies, procedures, and regulations.
• Interprets guidelines to determine appropriate courses of action in ambiguous situations.
• Follows established guidelines and turnaround times for processing QIO fast track appeals and expedited authorization requests.

Skills

1-3 years experience

Microsoft Word

Microsoft Excel

Attention to detail

Communication skills

Healthcare clerical experience

Independent in agile environment

Job description

Humana Inc invites a Compliance (UM) Coordinator 3 to review utilization management activities and documentation, ensuring compliance with policies and regulations while analyzing data to drive operational success.

This remote role supports a three-day, 12-hour shift schedule (Friday–Monday) with hours between 8:00 a.m. and 9:00 p.m. ET and may require occasional travel for training or meetings.