Remote Utilization Management Coordinator

Humana, Inc.; Bismarck (ND); Remote; USD 40,000 - 52,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k)

Paid time off

Disability Insurance

Life Insurance

Job summary

Humana, Inc. is seeking a UM Administration Coordinator to support utilization management operations remotely. The role involves provider/member-facing phone support and back-office tasks, reporting to the Supervisor, UM Management.

Shifts are 8 hours, include one weekend day and holiday rotation, with mandatory training in the first month from 8:00 AM to 4:30 PM CST. A wired internet connection and distraction-free workspace are required.

Qualifications

• Minimum of 2 years of customer service experience.
• Experience handling a high-volume calls (30–50 daily) across multiple systems.
• Typing speed of at least 30 words per minute.
• Proficient in Microsoft Office tools and features.
• A wired internet connection is required.
• A dedicated, distraction-free home workspace with webcam capability.

Responsibilities

• Handle provider/member-facing calls about prior authorizations, utilization management, and benefits.
• Process and review prior authorization requests and documentation to support medical necessity determinations.
• Perform back-office administrative tasks, including case research and data entry.
• Enter and verify information across multiple systems and document interactions.
• Monitor work queues to meet SLA and turnaround times.
• Collaborate with clinical and operational teams to resolve issues.

Skills

Customer service

High-volume calls

Typing 30 wpm

MS Office proficiency

Wired internet

Distraction-free workspace

Tools

Microsoft Office

Job description

Humana, Inc. is seeking a UM Administration Coordinator to support utilization management operations remotely. The role involves provider/member-facing phone support and back-office tasks, reporting to the Supervisor, UM Management.

Shifts are 8 hours, include one weekend day and holiday rotation, with mandatory training in the first month from 8:00 AM to 4:30 PM CST. A wired internet connection and distraction-free workspace are required.