Remote Utilization Management Coordinator

Humana Inc; United States; Remote; USD 40.000 - 52.000; Vollzeit

Benefits dieser Stelle

Remote work

Training & development

Competitive benefits

Zusammenfassung

Humana Inc. is seeking an UM Administration Coordinator to support UM operations through provider and member phone support and back-office administrative duties.

This remote role reports to the Supervisor, UM Management and requires 8-hour shifts ending by 7:00 PM CST/8:00 PM EST, with one weekend day and holiday rotation. You will handle prior authorizations, utilization management tasks, manage high call volumes, perform case research, data entry, and coordinate with clinical and operational

Qualifikationen

• Minimum of 2 years of customer service experience.
• Experience managing a high-volume of calls (approximately 30 to 50 daily) using multiple computer systems while engaging callers.
• Typing proficiency of at least 30 words per minute.
• Proficient experience using Microsoft Office (including toolbars, menus, and system features to locate documents).
• Direct wired internet connection required (Wi-Fi not permitted).
• Dedicated, distraction‑free workspace with webcam for meetings and training.

Aufgaben

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

Kenntnisse

Customer service

Phone support

Typing 30 wpm

MS Office

Wired internet

Remote workspace

Jobbeschreibung

Humana Inc. is seeking an UM Administration Coordinator to support UM operations through provider and member phone support and back-office administrative duties.

This remote role reports to the Supervisor, UM Management and requires 8-hour shifts ending by 7:00 PM CST/8:00 PM EST, with one weekend day and holiday rotation. You will handle prior authorizations, utilization management tasks, manage high call volumes, perform case research, data entry, and coordinate with clinical and operational