Remote Utilization Management Admin Coordinator

Humana Inc; United States; Remote; USD 40,000 - 52,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k)

Job summary

Humana Inc. is seeking an Utilization Management Administration Coordinator to support non-clinical processes ensuring appropriate care for members.

This fully remote role reports to the UM Manager within the Home Solutions organization, aligning with SNF services and collaborations with CenterWell and Onehome. The position requires administrative experience, proficiency with Word/Outlook/Excel, and the ability to learn new systems.

Qualifications

• 1+ years' experience in an administrative support capacity.
• Proficient with Microsoft Word, Outlook and Excel and able to type and enter data.
• Ability to learn new systems and adapt to changing processes.

Responsibilities

• Manage NLPs for chart reviews for the nursing team.
• Build and pend authorizations for review.
• Make inbound/outbound calls to engage providers and members to verify clinical information and admission status.
• Document completed calls and attach clinical information.
• Request clinical information from providers/facilities.
• Create written correspondence and determination letters.
• Collaborate with multiple roles and departments.

Skills

Administrative support experience

Data entry

Communication

Ability to learn new systems

Tools

Microsoft Word

Outlook

Excel

EMR/EHR systems

Job description

Humana Inc. is seeking an Utilization Management Administration Coordinator to support non-clinical processes ensuring appropriate care for members.

This fully remote role reports to the UM Manager within the Home Solutions organization, aligning with SNF services and collaborations with CenterWell and Onehome. The position requires administrative experience, proficiency with Word/Outlook/Excel, and the ability to learn new systems.