Remote Utilization Management Coordinator

Humana; Kentucky; On-site; USD 40,000 - 52,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) retirement savings plan

Paid time off

Disability insurance

Life insurance

Job summary

Humana is seeking a PH UM Administration Coordinator 2 to contribute to PH utilization management administration. The UM Administration Coordinator 2 provides non-clinical support for UM Nurses and PH Medical Directors to ensure the best and most appropriate treatment, care or services for members.

The role processes requests for authorization of health services, requiring interpretation of area/department policy and methods for completing assignments.

Qualifications

• 1+ year administrative or technical support experience.
• Proficient in MS Office (Word, Excel, Outlook) in Windows.
• Experience with medical terminology and ICD-10 codes preferred.
• Bachelor's Degree in Business, Finance or related field.
• Prior member service or customer service telephone experience desired.
• Experience with Utilization Review and/or Prior Authorization in managed care.

Responsibilities

• Assist in administration of PH utilization management.
• Provide non-clinical support for UM Nurses and PH Medical Directors.
• Process requests for authorization of health services.
• Interpret area/department policy and methods for completing assignments.
• Identify work priorities within defined parameters and follow standard policies.

Skills

Admin support experience

MS Office

Customer-focused

Education

Bachelor's Degree in Business, Finance or related field

Tools

EMR systems

ICD-10 familiarity

Job description

Humana is seeking a PH UM Administration Coordinator 2 to contribute to PH utilization management administration. The UM Administration Coordinator 2 provides non-clinical support for UM Nurses and PH Medical Directors to ensure the best and most appropriate treatment, care or services for members.

The role processes requests for authorization of health services, requiring interpretation of area/department policy and methods for completing assignments.