Utilization Management Coordinator

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

Job summary

Humana Inc. in the United States seeks a UM Administration Coordinator 2 to support utilization management administration. This remote role processes health service authorization requests and provides non-clinical support to UM Nurses and PH Medical Directors to ensure appropriate care for members.

Strong MS Office skills and 1+ years of administrative/technical experience are required; travel to Humana offices may be needed occasionally.

Qualifications

• 1+ years administrative or technical support experience.
• Working knowledge of MS Office (Word, Excel, Outlook) in Windows.
• Preferred experience in utilization review or managed care.

Responsibilities

• Process requests for authorization of health services following policy.
• Provide non-clinical support to UM Nurses and PH Medical Directors.

Skills

Administrative support

Microsoft Office

Customer service

Education

Bachelor's Degree in Business, Finance or related field

Tools

MS Office Suite

Job description

Become a part of our caring community The Physical Health, PH ,UM Administration Coordinator 2 contributes to administration of PH utilization management. The UM Administration Coordinator 2 provides non-clinical support for UM Nurses and PH Medical Directors to ensure the best and most appropriate treatment, care or services for members. The UM Administration Coordinator 2 processes requests for authorization of health services, requiring interpretation of area/department policy and methods for completing assignments. The UM Coordinator works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion. Use your skills to make an impact

Required Qualifications

• 1 or more years administrative or technical support experience
• Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Proficient utilizing electronic medical record and documentation programs
• Proficient and/or experience with medical terminology and/or ICD-10 codes
• Bachelor's Degree in Business, Finance or a related field
• Prior member service or customer service telephone experience desired
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

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

$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

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.