Remote Utilization Management Coordinator

Humana, Inc.; Augusta (ME); Remote; USD 40,000 - 52,000; Full time

Benefits offered by this job

Health benefits

401(k) plan

Paid time off

Disability insurance

Life insurance

Job summary

Humana, Inc. is hiring a UM Administration Coordinator to support utilization management operations from a remote work setup. You will handle provider and member calls, process prior authorizations, and perform back-office tasks to ensure accurate documentation and timely case processing.

The role includes training, weekend rotation, and adherence to service levels. The candidate should have at least 2 years of customer service experience, strong computer skills, and a dedicated wired internet

Qualifications

• Minimum of 2 years of customer service experience.
• Experience managing a high-volume of calls (30–50 daily) using multiple computer systems.
• Typing proficiency of at least 30 words per minute.
• Proficient experience using Microsoft Office.
• A dedicated wired internet connection is required (Wi-Fi not permitted).
• A dedicated, distraction-free workspace with webcam for meetings.

Responsibilities

• Handle inbound and outbound calls about prior authorizations and benefits, with 30–50 daily interactions.
• Process and review prior authorization requests and documentation to support medical necessity determinations.
• Perform back-office administrative tasks including case research and updates.
• Review, verify, and enter information across multiple systems and document interactions.
• Complete and monitor work queues to meet SLAs and turnaround times.
• Collaborate with clinical and operational teams to resolve issues.

Skills

Customer service

High-volume calls

Typing 30 wpm

Microsoft Office

Dedicated wired internet

Webcam workspace

Tools

Microsoft Office

Electronic Medical Records

Job description

Humana, Inc. is hiring a UM Administration Coordinator to support utilization management operations from a remote work setup. You will handle provider and member calls, process prior authorizations, and perform back-office tasks to ensure accurate documentation and timely case processing.

The role includes training, weekend rotation, and adherence to service levels. The candidate should have at least 2 years of customer service experience, strong computer skills, and a dedicated wired internet