FreshRemote.Work

UM Administration Coordinator 2

Remote US, United States

Become a part of our caring community and help us put health first
 The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

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 are typically focus on interpretation of area/department policy and methods for completing assignments. 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. This UM Administration Coordinator 2 position will be focused on completing both approval and adverse determination letters.


Use your skills to make an impact
 

Required Qualifications

  • Experience with Utilization Review and/or Prior Authorization, within CIT (Clinical Intake Team)
  • Bilingual (English/Spanish, written and verbal), with ability to successfully complete translator certification
  • CGX Authorization Builds and queue routing
  • Ability to maneuver and follow UM process flows
  • Genesys experience
  • Ability to work the following hours: Monday, Tuesday and Friday 11:00am-8:00pm EST and Saturday/Sunday 9:00am-6:00pm EST
  • Demonstrated ability to articulate ideas effectively in both written and oral forms
  • Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems

Preferred Qualifications

  • Prior member service or customer service telephone experience desired

Additional Information

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.
  • Satellite, cellular and microwave connection can be used only if approved by leadership.
  • Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  • Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 03-06-2025
About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.


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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

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Job Profile

Regions

North America

Countries

United States

Restrictions

California Dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Illinois Montana Must meet internet speed requirements Remote US South Dakota Work from a dedicated space Work from a dedicated space lacking ongoing interruptions Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Work from home in specific states Work from Home in the state of California, Illinois, Montana, or South Dakota

Benefits/Perks

401k retirement 401k Retirement Savings Caring community Competitive benefits Dental Disability Health first Holidays Internet expense reimbursement Life Life Insurance Medical Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Smart healthcare decisions Support whole-person well-being Telephone equipment provided Time off Vision Vision Benefits Volunteer time Volunteer time off Whole-person well-being Work From Home

Tasks
  • Administration of utilization management
  • Completing approval and adverse determination letters
  • Customer Service
  • Customer support
  • Identify work expectations
  • Interpretation
  • Performing administrative support
  • Training
  • Utilization Management
Skills

Administrative Articulate Authorization BI Bilingual Bilingual (English Bilingual English/Spanish Bilingual (Spanish) Business CGX Clinical Clinical support Compensation Computations Customer service Customer Support Dental Education Excel Genesys Healthcare Healthcare services HIPAA Insurance IT Leadership Life Insurance Management Medicaid Medicare MS Office Outlook Policy Prior authorization Prioritization Process Flows Recruitment Routing Security Spanish Support Technology Training Translator certification Utilization management Utilization Review Vision Wellness Windows Word

Experience

2 years

Education

Associate Business Education English Healthcare Higher IT Management MS

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9