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UM Administration Coordinator - Remote US

Become a part of our caring community and help us put health first
 The UM Administration Coordinator 2 provides clerical support for the department. We are the beginning, middle and end of processes for utilization management. This role partners with leadership, Medical Directors, Nurses and with other team members.

Achieve your best at Humana. Join Us! 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.

Key Responsibilities:

  • Attaching faxes for chart reviews for the nursing team

  • Answering departmental phones as assigned

  • Make outbound calls to engage providers to verify clinical information/discharge date and admission status

  • Document calls and attach clinical information received

  • Request clinical information from providers/facilities

  • Create and send out written correspondence

  • Ability to multitask and prioritize

  • Creation and distribution of determination letters

  • Collaborate with multiple roles/departments/providers/team members


Use your skills to make an impact
 

Required Qualifications

  • 1 or more years’ experience working in an administrative support capacity in the healthcare industry

  • Prior professional experience of Microsoft Word, Outlook and Excel with the ability to type and enter data accurately, as well as the ability to quickly learn new systems (proficient to advanced)

  • Prior experience in a metric driven environment

Preferred Qualifications

  • Proficient utilizing electronic medical record and documentation programs

  • Proficient and/or experience with medical terminology and/or ICD-10 codes

  • Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

Additional Information

  • Hours for this role are: Monday – Friday, 8-hour shift will fall between the hours of 7:00am-7:00pm EST and a Saturday rotation may be required based on business needs  

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.

Work at Home / Internet Statement

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 recommended; 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

Alert: 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.


 

$37,200 - $51,200 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.
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 because he or she is a protected veteran. 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

Benefits/Perks

401(k) retirement savings plan Competitive benefits Dental Life Insurance Medical Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Personal holidays Time off Vision Vision Benefits Volunteer time Volunteer time off

Skills

BI Business Data Documentation Electronic Medical Record Systems Excel Healthcare HIPAA ICD-10 Codes Leadership Managed Care Medicaid Medical terminology Medicare Microsoft Word Nursing Outlook Prior authorization Security Technology Utilization management Utilization Review Wellness

Tasks
  • Answer departmental phones
  • Attach faxes for chart reviews
  • Collaborate with multiple roles/departments/providers/team members
  • Create and send out written correspondence
  • Creation and distribution of determination letters
  • Documentation
  • Document calls and attach clinical information
  • Make outbound calls to engage providers
  • Request clinical information from providers
  • Training
Experience

1 year

Education

Business

Restrictions

Internet speed requirements Payment for internet expense in specific states Remote US Work from a dedicated space Work from a dedicated space lacking ongoing interruptions

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