UM Administration Coordinator 7AM-6PM EST Sat-Tues or 7AM-6PM EST Thurs-Sun

Profile

Description

The UM Administration Coordinator provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members.

Responsibilities

The Utilization Management Coordinator functions under the direction of the Supervisor, Utilization Management to coordinate, generate and track both incoming and outgoing correspondence, related to the member for services or prospective services. Interacts with members, providers, facilities and other Humana staff to implement the program interventions, facilitate receipt of information and records for prompt review and response by the clinical staff.

Supports the daily operations of Utilization Management team through interaction with staff, facilities, vendors and providers

Maintains a current knowledge base of Utilization Management processes and timelines

Transfers calls from members and providers to appropriate departments

Uses good listening skills, meets both productivity and performance expectations as identified by departmental supervisor

Creates, updates maintains and/or closes authorizations or tasks for services as assigned within process guidelines

Processes all incoming and outgoing correspondence/faxes in accordance with required standards and within respective timeliness guidelines

Demonstrates a professional and courteous manner when communicating with others with the ability to clearly and accurately state the agreed upon resolution

Adheres to Humana Policies and Procedures, process standards, and Standard Operating Procedures

Performs other related duties and projects as assigned within the assigned timeframes

Complies with Humana and HIPAA confidentiality standards to protect the confidentiality of member information

In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:

Medical Benefits

Dental Benefits

Vision Benefits

Health Savings Accounts

Flex Spending Accounts

Life Insurance

401(k)

PTO including 7 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time

And more

Required Qualifications

1 years administrative or technical support experience

Excellent verbal and written communication skills

Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment

Ability to quickly learn new systems

Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

This position will require weekend hours with one weekend off per quarter

Preferred Qualifications

Prior call center experience

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

This position is either 7AM-6PM EST Thurs-Sun or 7AM-6PM EST Sat-Tues. There will be one weekend off per quarter.

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Work at Home/Remote Requirements

Work-At-Home Requirements

WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.

Satellite and Wireless Internet service is NOT allowed for this role.

A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Our Hiring Process

As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.

If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews

If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m (satellite and/or wireless internet connections are NOT permitted for Work at Home roles) and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. #ThriveTogether #WorkAtHome

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.

Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com