Remote Utilization Management Coordinator

Humana, Inc.; Boise (ID); Remote; USD 40,000 - 52,000; Full time

Benefits offered by this job

Medical, dental and vision benefits

401(k) retirement savings plan

Paid time off and holidays

Short-term and long-term disability

Life insurance

Job summary

Humana, Inc. is seeking a remote Utilization Management Administration Coordinator to support UM operations. You will handle provider/member calls, review prior authorizations, and perform back-office tasks, reporting to the Supervisor, UM Management.

The role includes training and cross-training across UM functions and requires a dedicated home workspace. The position emphasizes strong organization, attention to detail, and commitment to exceptional service for providers, members, and internal

Qualifications

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

Responsibilities

• Handle inbound and outbound calls about prior authorizations, utilization management services, and benefits; ~30–50 daily interactions for phone support.
• Process and review prior authorization requests and documentation for medical necessity determinations and authorization workflows.
• Perform back-office administrative tasks, including case research, record updates, error resolution, and timely case processing.
• Review, verify, and enter information across multiple systems; document interactions, research, and case activities.
• Complete and monitor assigned work queues to meet SLAs and turnaround times.
• Collaborate with clinical and operational teams to resolve issues and address escalated concerns.

Skills

Customer service

High-volume calls

Typing 30 wpm

Microsoft Office

Wired internet

Dedicated home workspace

Tools

Microsoft Office

Job description

Humana, Inc. is seeking a remote Utilization Management Administration Coordinator to support UM operations. You will handle provider/member calls, review prior authorizations, and perform back-office tasks, reporting to the Supervisor, UM Management.

The role includes training and cross-training across UM functions and requires a dedicated home workspace. The position emphasizes strong organization, attention to detail, and commitment to exceptional service for providers, members, and internal