Remote Utilization Management Coordinator

Humana Inc; Wisconsin; Hybrid; USD 40,000 - 52,000; Full time

Job summary

Humana Inc. in Wisconsin is seeking a Utilization Management Coordinator to support prior authorization processes for the iCare team. The role involves handling PA requests, provider outreach, and coordination with clinical staff to ensure appropriate patient care.

The position is remote with optional office collaboration, requires 40 hours per week, and follows CST business hours. Responsibilities include accurate data entry, documentation, and multi-tasking to serve multiple stakeholders.

Qualifications

• 1 year of experience in health care or health plan setting.
• 1–2 years of experience with Word, Excel, PowerPoint.
• 1 year of customer service with inbound/outbound calls.
• Work hours 8:30–5pm CST, Monday–Friday; limited holiday coverage.

Responsibilities

• Process and document all inpatient/outpatient prior authorization requests per Humana policies.
• Contact providers by phone or fax for additional information.
• Make inbound/outbound calls to track PA status with providers and customers.
• Enter PA requests into TruCare and prepare documentation for clinical review.

Skills

Microsoft Office (Word, Excel, PowerP

Customer service

Communication

Tools

TruCare

Job description

Humana Inc. in Wisconsin is seeking a Utilization Management Coordinator to support prior authorization processes for the iCare team. The role involves handling PA requests, provider outreach, and coordination with clinical staff to ensure appropriate patient care.

The position is remote with optional office collaboration, requires 40 hours per week, and follows CST business hours. Responsibilities include accurate data entry, documentation, and multi-tasking to serve multiple stakeholders.