[Hiring] Utilization Management Coordinator @Humana

Role Description

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.

• Processes requests for authorization of health services, requiring interpretation of area/department policy and methods for completing assignments.
• Works within defined parameters to identify work expectations and quality standards, with some latitude over prioritization/timing, and minimal direction.
• Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

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.

Requirements

• 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:
  • Minimum download speed of 25 Mbps and upload speed of 10 Mbps required; wireless, wired cable or DSL connection suggested.
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: Occasional travel to Humana's offices for training or meetings may be required.

Benefits

• Competitive benefits that support whole-person well-being.
• 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.