Remote Utilization & Admin Coordinator

Socket.dev; Michigan; Hybrid; USD 40,000 - 52,000; Full time

Job summary

Humana is seeking an UM Administrative Coordinator to provide non-clinical support, ensuring adherence to policies and procedures for members’ care and services. You will manage mailboxes, enter data in systems, and prepare materials for LTSS Utilization Management reviewers.

Responsibilities include document preparation, timely submission of state-required deliverables, and collaboration with care coordinators and providers to facilitate access to care resources.

Qualifications

• Must reside in Michigan.
• 1+ years of administrative experience in a healthcare environment.
• Strong verbal and written communication skills to support stakeholder communication and coordination.
• Working knowledge of Microsoft Word, Excel, and Outlook in a Windows-based environment and the ability to learn new software and systems.

Responsibilities

• Provide LTSS UM support by managing shared mailboxes and entering data into work queues and/or clinical documentation systems.
• Mail letters/educational material, prepare documents for LTSS UM reviewers and Medical Directors, and perform other administrative responsibilities as assigned.
• Ensure the timely and correct submission of state-required deliverables.
• Work with care coordinators and other stakeholders who guide members toward resources for care and well-being.
• Perform clerical activities including computations, reporting data, tracking data, pulling reports, and monitoring email.

Skills

Administrative experience

Strong communication skills

Ability to learn new software

Tools

Microsoft Word

Excel

Outlook

EMR systems

Healthcare terminology

ICD-10 codes

Job description

Humana is seeking an UM Administrative Coordinator to provide non-clinical support, ensuring adherence to policies and procedures for members’ care and services. You will manage mailboxes, enter data in systems, and prepare materials for LTSS Utilization Management reviewers.

Responsibilities include document preparation, timely submission of state-required deliverables, and collaboration with care coordinators and providers to facilitate access to care resources.