Remote Utilization Management Admin Coordinator

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

Job summary

Humana is seeking an Utilization Management Administration Coordinator to provide non-clinical support for policies ensuring appropriate care for members. This fully remote role sits within Home Solutions, supporting the Skilled Nursing Facility segment with CenterWell and Onehome collaborations.

The UM Admin Coordinator will manage NLPs for chart reviews, build and pend authorizations, and handle calls to verify information and discharge status. Travel may be required occasionally.

Qualifications

• 1+ years of administrative support experience.
• Proficient in Microsoft Word, Outlook, and Excel and data entry.
• Ability to learn new systems quickly.

Responsibilities

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

Skills

Administrative support

Word

Outlook

Excel

Data entry

Systems navigation

Tools

CGX

SRO

HCHB

Job description

Humana is seeking an Utilization Management Administration Coordinator to provide non-clinical support for policies ensuring appropriate care for members. This fully remote role sits within Home Solutions, supporting the Skilled Nursing Facility segment with CenterWell and Onehome collaborations.

The UM Admin Coordinator will manage NLPs for chart reviews, build and pend authorizations, and handle calls to verify information and discharge status. Travel may be required occasionally.