Remote Utilization Coordinator: Medicaid Prior Authorizations

Humana; Wisconsin; Remoto; USD 40.000 - 52.000; Tempo integral

Benefícios oferecidos por esta vaga

Work from home

Resumo da vaga

Humana is seeking a Utilization Management (UM) Coordinator to join the Wisconsin Medicaid Market (iCare) team, reporting to the UMPA Administrative Supervisor. This remote role supports policies and procedures to ensure appropriate treatment and services for members.

Responsibilities include processing PA requests, contacting providers, entering data into TruCare, and coordinating with internal/external stakeholders. Hours are 8:30 am–5:00 pm CST, Monday–Friday.

Qualificações

• 1 year of experience in a health care or health plan setting.
• 1–2 years of experience with Word, Excel, and PowerPoint.
• 1 year of customer service experience with inbound/outbound calls.
• Ability to work 8:30–17:00 CST, M–F (limited holiday coverage).

Responsabilidades

• Process and document inbound and outbound PA requests per Humana policies.
• Call providers by phone or fax for additional information as needed.
• Enter PA requests into the TruCare database and route to clinical staff.
• Communicate status of PA requests to customers/providers.
• Multi-task to meet needs of multiple stakeholders.

Conhecimentos

Health care experience

Microsoft Office

Customer service

Time management

Ferramentas

TruCare database

Descrição da vaga

Humana is seeking a Utilization Management (UM) Coordinator to join the Wisconsin Medicaid Market (iCare) team, reporting to the UMPA Administrative Supervisor. This remote role supports policies and procedures to ensure appropriate treatment and services for members.

Responsibilities include processing PA requests, contacting providers, entering data into TruCare, and coordinating with internal/external stakeholders. Hours are 8:30 am–5:00 pm CST, Monday–Friday.