Remote Utilization Management Coordinator

Humana, Inc.; Lansing (MI); Remote; USD 40,000 - 52,000; Full time

Job summary

Humana, Inc. seeks an UM Administration Coordinator (UMAC 2) to support utilization management operations. This remote role reports to the Supervisor, UM Management and focuses on provider/member-facing calls and back-office tasks.

The position entails 40-hour weeks, shifts ending by 7:00 PM CST/8:00 PM EST, and one weekend day with holiday rotation. Mandatory training is conducted Monday through Friday 8:00 AM–4:30 PM CST.

Qualifications

• Minimum 2 years of customer service experience.
• Experience handling high-volume calls and navigating multiple computer systems.
• Typing proficiency of at least 30 words per minute.
• Proficient use of Microsoft Office.
• Wired internet connection required; workspace with webcam for meetings.

Responsibilities

• Handle inbound and outbound calls about prior authorizations, utilization management services, and benefits.
• Process and review prior authorization requests and documentation; support medical necessity determinations.
• Perform back-office administrative tasks including case research and data entry across multiple systems.
• Complete and monitor work queues to meet service levels and deadlines.
• Collaborate with clinical and operational teams to resolve issues and escalate concerns.

Skills

Customer service

Phone support

Typing 30 wpm

Tools

Microsoft Office

Job description

Humana, Inc. seeks an UM Administration Coordinator (UMAC 2) to support utilization management operations. This remote role reports to the Supervisor, UM Management and focuses on provider/member-facing calls and back-office tasks.

The position entails 40-hour weeks, shifts ending by 7:00 PM CST/8:00 PM EST, and one weekend day with holiday rotation. Mandatory training is conducted Monday through Friday 8:00 AM–4:30 PM CST.