Remote Utilization & Prior Authorization Coordinator - WI

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

Job summary

Humana Inc. is seeking a Utilization Management (UM) Coordinator to support the Wisconsin Medicaid iCare team. This remote role focuses on processing prior authorizations, coordinating with providers, and documenting actions in the TruCare system to ensure compliant, timely care for members.

Ideal candidates have 1 year in health care or health plan settings, strong MS Office skills, and excellent customer service. The position offers weekday hours, remote work, and competitive benefits.

Qualifications

• 1 year of experience in a health care setting or health plan setting.
• 1 year of customer service experience with inbound/outbound calls.
• Strong MS Office skills (Word, Excel, PowerPoint).

Responsibilities

• Process and document all incoming inpatient and outpatient prior authorization (PA) requests as outlined by Humana policies and procedures.
• Contact providers via phone or fax to request additional information or clarification as needed per established process.
• Conduct inbound and outbound calls with customers/providers regarding PA status.
• Enter PA requests into the prior authorization database (TruCare) and prepare documentation for clinical review.

Skills

Health care experience

Microsoft Office

Customer service

Tools

TruCare database

Job description

Humana Inc. is seeking a Utilization Management (UM) Coordinator to support the Wisconsin Medicaid iCare team. This remote role focuses on processing prior authorizations, coordinating with providers, and documenting actions in the TruCare system to ensure compliant, timely care for members.

Ideal candidates have 1 year in health care or health plan settings, strong MS Office skills, and excellent customer service. The position offers weekday hours, remote work, and competitive benefits.