Remote Utilization Management Specialist

Humana, Inc.; Olympia (WA); Remote; USD 40,000 - 52,000; Full time

Benefits offered by this job

Medical benefits

401(k) retirement plan

Paid time off

Disability insurance

Life insurance

Job summary

Humana, Inc. is seeking a remote Utilization Management Administration Coordinator to support UM operations through provider/member-facing phone support and back-office tasks.

The role involves 40-hour weeks with weekend and holiday rotation, and a mandatory training period in CST/EST. You will help navigate prior authorizations, utilization management processes, and related documentation from a home office.

Qualifications

• Minimum of 2 years of customer service experience.
• Experience managing a high-volume of calls (approximately 30 to 50 calls daily).
• Typing proficiency of at least 30 words per minute.
• Proficient in Microsoft Office (toolbars, menus, system features).
• Direct wired internet connection required (Wi‑Fi not permitted).
• Dedicated, distraction-free home 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 for medical necessity determinations.
• Perform back-office administrative tasks including case research, record updates, and error resolution.
• Review, verify, and enter information across multiple systems; document interactions and case activities.
• Complete and monitor work queues to meet service level agreements and turnaround times.
• Collaborate with clinical and operational teams to resolve issues and escalated concerns.

Skills

Customer service

High-volume calls

Typing 30 wpm

MS Office

Wired internet

Home/remote workspace

Job description

Humana, Inc. is seeking a remote Utilization Management Administration Coordinator to support UM operations through provider/member-facing phone support and back-office tasks.

The role involves 40-hour weeks with weekend and holiday rotation, and a mandatory training period in CST/EST. You will help navigate prior authorizations, utilization management processes, and related documentation from a home office.