Company name
Humana Inc.
Location
Glen Allen, VA, United States
Employment Type
Full-Time
Industry
Administrative
Posted on
Dec 14, 2022
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 Fri, Sat, Sun, Mon 7a-6pm EST
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
Work at Home/Remote Requirements
Work-At-Home Requirements:
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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
Associates 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 associates 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
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
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Company info
Humana Inc.
Website : http://www.humana.com