Remote Utilization Management Specialist

Humana, Inc.; Jackson (MS); Remote; USD 40,000 - 52,000; Full time

Job summary

Humana, Inc. is seeking a UM Administration Coordinator (UMAC 2) to support UM operations from a remote position.

You will handle provider and member calls, process prior authorizations, and perform back-office tasks under supervision in a 40-hour schedule with weekend rotations. The role requires 2+ years of customer service, ability to manage 30–50 daily calls, typing 30 wpm, proficiency in Microsoft Office, and a dedicated wired home workspace.

Qualifications

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

Responsibilities

• Handle inbound and outbound calls about prior authorizations, utilization management services, and benefits; ~30–50 interactions daily when on phone support.
• Process and review prior authorization requests and documentation for medical necessity determinations and workflows.
• Perform back-office administrative tasks, including case research, record updates, error resolution, and timely case processing.
• Review, verify, and enter accurate information across multiple systems; document interactions and research findings per procedures.
• Complete and monitor assigned work queues to meet service levels 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 workspace

Tools

Microsoft Office

Job description

Humana, Inc. is seeking a UM Administration Coordinator (UMAC 2) to support UM operations from a remote position.

You will handle provider and member calls, process prior authorizations, and perform back-office tasks under supervision in a 40-hour schedule with weekend rotations. The role requires 2+ years of customer service, ability to manage 30–50 daily calls, typing 30 wpm, proficiency in Microsoft Office, and a dedicated wired home workspace.