[Hiring] UM Administration Coordinator @Humana

Role Description

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 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.

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.

Requirements

• 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.

Benefits

• 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.

Company Description

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.