UM Administration Coordinator

About the Role

The UM Administration Coordinator 2 contributes to the administration of utilization management. This role performs varied and moderately complex administrative, operational, and customer support assignments, including performing computations. You will typically work on semi-routine assignments, providing non-clinical support for policies and procedures to ensure the best and most appropriate treatment, care, or services for members. Your decisions will focus on interpreting area/department policies and methods for completing assignments. You will work within defined parameters but have some latitude over prioritization and timing, operating under minimal direction and following standard policies with room for interpretation and independent discretion.

Key Responsibilities

• Provide non-clinical support for utilization management policies and procedures.
• Perform administrative and operational tasks.
• Handle moderately complex assignments.
• Interpret and apply company policies and methods.
• Manage work expectations and quality standards with some autonomy.

Required Qualifications

• 2+ years of administrative or similar job experience.
• 2+ years of claims experience.
• 2+ years of experience with Utilization Review and/or Prior Authorization within a managed care organization.
• Excellent verbal and written communication skills.
• Working knowledge of MS Office (Word, Excel, Outlook) in a Windows environment and ability to quickly learn new systems.

Preferred Qualifications

• Proficient in utilizing electronic medical record and documentation programs.
• Proficient and/or experienced with medical terminology and/or ICD-10 codes.
• Prior member service or customer service telephone experience.

Work Environment & Schedule

• Schedule: Monday through Friday, 8:00 AM – 5:00 PM ET or CT zone, with flexibility for overtime.
• Work Location: US Nationwide (Stateside).
• Work Style: Remote (Work-at-Home).
• Internet Requirements: Minimum 25 Mbps download, 10 Mbps upload. Wired, DSL, or cable preferred; satellite/cellular/microwave with leadership approval. Internet expense reimbursement provided for residents of California, Illinois, Montana, or South Dakota.
• Work Space: Dedicated, interruption-free space to protect member PHI/HIPAA information.
• Equipment: Humana provides necessary telephone equipment.
• Travel: Occasional travel to Humana offices for training or meetings may be required.

Interview Process

This role utilizes HireVue, an interviewing technology, for a streamlined and efficient hiring process.

Compensation and Benefits

• Pay Range: $40,000 - $52,300 per year.
• Benefits: Humana offers competitive benefits including medical, dental, vision, 401(k) retirement savings, paid time off, holidays, volunteer time off, paid parental and caregiver leave, disability insurance, life insurance, and more, supporting whole-person well-being.

About Humana

Humana Inc. is a leading U.S. healthcare company focused on making it easier for millions of people to achieve their best health through its insurance services and CenterWell healthcare services. They serve people with Medicare and Medicaid, families, individuals, military service personnel, and communities, aiming to improve quality of life.

Key skills/competency

• Utilization Management Administration
• Claims Processing
• Prior Authorization
• Managed Care Experience
• Administrative Support
• MS Office Suite
• Communication Skills
• HIPAA Compliance
• Medical Terminology
• Customer Service