UM Administration Coordinator

Socket.dev; Michigan; Hybrid; USD 40,000 - 52,000; Full time

Job summary

Humana is seeking an UM Administrative Coordinator to provide non-clinical support, ensuring adherence to policies and procedures for members’ care and services. You will manage mailboxes, enter data in systems, and prepare materials for LTSS Utilization Management reviewers.

Responsibilities include document preparation, timely submission of state-required deliverables, and collaboration with care coordinators and providers to facilitate access to care resources.

Qualifications

• Must reside in Michigan.
• 1+ years of administrative experience in a healthcare environment.
• Strong verbal and written communication skills to support stakeholder communication and coordination.
• Working knowledge of Microsoft Word, Excel, and Outlook in a Windows-based environment and the ability to learn new software and systems.

Responsibilities

• Provide LTSS UM support by managing shared mailboxes and entering data into work queues and/or clinical documentation systems.
• Mail letters/educational material, prepare documents for LTSS UM reviewers and Medical Directors, and perform other administrative responsibilities as assigned.
• Ensure the timely and correct submission of state-required deliverables.
• Work with care coordinators and other stakeholders who guide members toward resources for care and well-being.
• Perform clerical activities including computations, reporting data, tracking data, pulling reports, and monitoring email.

Skills

Administrative experience

Strong communication skills

Ability to learn new software

Tools

Microsoft Word

Excel

Outlook

EMR systems

Healthcare terminology

ICD-10 codes

Job description

Become a part of our caring community

The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Decisions typically focus on interpretation of area/department policy and methods for completing assignments. You will work within defined parameters to identify work expectations and quality standards, but have some latitude over prioritization/timing, and works under minimal direction. You will follow standard policies and practices that allow for some opportunity for interpretation/deviation and independent discretion.

• Provide Long- Term Services and Supports (LTSS) UM support by managing shared mailboxes and entering data into work queues and/or clinical documentation systems.
• Mail letters/educational material, prepare documents for LTSS UM (Utilization Management) reviewers and Medical Directors, and perform other administrative responsibilities as assigned.
• Ensure the timely and correct submission of state-required deliverables.
• Work with care coordinators and other internal and external stakeholders who guide members and their families toward and facilitate interaction with resources appropriate for care and well-being.
• Perform varied activities of clerical activities including perform computations, reporting data, tracking data, pulling reports and monitoring/managing email.
• Typically work on semi-routine assignments that are subject to change.
• May make, receive, and soft transfer calls to and from members, member's families and providers.
• Ensure timely communication and follow up occurs with care management.

Use your skills to make an impact

Required Qualifications

• Must reside in Michigan.
• One (1) or more years of administrative experience in a healthcare environment.
• Strong verbal and written communication skills to support stakeholder communication and coordination.
• Working knowledge of Microsoft Word, Excel, and Outlook in a Windows-based environment and the ability to learn new software and systems.

Preferred Qualifications

• Experience with LTSS programs.
• Experience with LTSS Utilization Review and/or Prior Authorization, preferably within a managed care organization.
• Proficient using electronic medical record and documentation programs.
• Proficient or experienced with medical terminology and/or ICD-10 codes.
• Prior member service or customer service telephone experience.

Additional Information

• Workstyle: This position is remote.
• Work Schedule: Monday through Friday; 8:00 a.m. to 4:30 p.m. Eastern Time (ET), with flexibility to work additional hours as needed to support business priorities and operational demands.
• Training: The training period for this position is approximately 4 to 6 weeks and may require attendance outside of standard working schedule. We require full participation throughout onboarding and training to ensure successful completion of the program. While time off is generally not permitted during this period, we consider limited accommodations for essential needs on a case-by-case basis.

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$40,000 - $52,300 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.