UM Administration Coordinator 2

About the Role

The Utilization Management (UM) Coordinator plays a vital role in the administration of UM processes. This position involves performing a variety of moderately complex administrative, operational, and Enrollee support tasks, including computations and working on semi-routine assignments.

Position Responsibilities

• Provides non-clinical support for policies and procedures, ensuring optimal treatment, care, or services for Enrollees.
• Assists Providers with discharge planning for Enrollees experiencing inpatient stays or outpatient physical health needs.
• Collaborates with the clinical team on special projects.
• Completes Provider-facing responsibilities.

Qualifications

Required Qualifications

• Minimum of 1 year of experience in administrative or technical support.
• Proficiency in MS Office (Word, Excel, Outlook) within a Windows environment, with the ability to learn new systems quickly.
• A passion for contributing to an organization dedicated to improving consumer experiences.

Preferred Qualifications

• Experience with electronic medical record and documentation programs.
• Prior experience with Utilization Review and/or Prior Authorization, preferably in a managed care setting.
• Proficiency and/or experience with medical terminology and/or ICD-10 codes.
• Bachelor's Degree in Business, Finance, or a related field.
• Previous member or customer service telephone experience is a plus.

Additional Information

• Availability to work occasional Saturday rotations is required.

Work-From-Home (WFH) Internet Requirements

To ensure the security and reliability of remote work, employees working from home or a hybrid office/home setup must meet the following internet criteria:

• A minimum download speed of 25 Mbps and an upload speed of 10 Mbps is required. Wired cable or DSL connections are recommended.
• Satellite, cellular, or microwave connections may be used only with leadership approval.
• Employees working remotely in California, Illinois, Montana, or South Dakota will receive a bi-weekly internet expense stipend.
• Humana will provide appropriate telephone equipment for remote positions.
• A dedicated workspace free from interruptions is necessary to protect member Protected Health Information (PHI) and comply with HIPAA regulations.

Benefits

Humana offers a comprehensive benefits package designed to support the health and well-being of employees and their families, promoting financial security. Benefits include:

• Health benefits effective from day one.
• Paid time off, holidays, volunteer time, and jury duty pay.
• Recognition pay.
• 401(k) retirement savings plan with employer match.
• Tuition assistance.
• Scholarships for eligible dependents.
• Parental and caregiver leave.
• Employee charity matching program.
• Network Resource Groups (NRGs).
• Career development opportunities.

Hiring Process

HireVue

This role utilizes HireVue, an interviewing technology designed to streamline the hiring process and gather insights into relevant skills and experience at your convenience.

SSN Alert

Humana is committed to protecting personal identity. Applicants may be asked to provide their Social Security Number if not already on file. Instructions will be provided via email from [email protected] for secure submission.

Travel

While this position is remote, occasional travel to Humana offices for training or meetings may be required.

Schedule

• Scheduled Weekly Hours: 40

Pay Range

The estimated starting base pay for this full-time position (40 hours per week) is between $40,000 and $52,300 annually. Actual pay may vary based on geographic location, skills, knowledge, experience, education, and certifications.

Description of Benefits

Humana, Inc. and its affiliates offer competitive benefits supporting whole-person well-being, including medical, dental, and vision insurance, a 401(k) plan with employer match, various paid time off options, disability insurance, life insurance, and more.

About Us

Humana Inc. is a leading U.S. healthcare company providing insurance services and healthcare services through CenterWell. We aim to simplify achieving optimal health for millions of people, including those with Medicare and Medicaid, families, individuals, and military service personnel. Learn more at Humana.com and CenterWell.com.

Equal Opportunity Employer

Humana is an equal opportunity employer committed to diversity and inclusion. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. We take affirmative action to employ and advance individuals with disabilities or protected veteran status, ensuring all employment decisions are based on valid job requirements.