Humana
Utilization Management Administration Coordinator -- Home Health
- Remote Nationwide · Remote
- Full-time
- $40,000 - $52,300
- Posted
Skills
Job description
Become a part of our caring community
Full-Time, Remote Telephonic opportunity
The UM Administration Coordinator 2 supports the administration of utilization management by performing a variety of moderately complex administrative, operational, and customer service tasks.
Responsibilities may include significant telephonic interaction with providers, members, and other stakeholders, including receiving inbound calls, providing customer service, and supporting the intake of utilization management and prior authorization requests. Some associates may be assigned primarily or fully to telephonic responsibilities based on business needs.
Additional responsibilities may include creating and processing authorization cases, generating correspondence, triaging faxes and shared mailboxes, processing documentation, conducting calculations and data processing, and performing other administrative functions supporting utilization management. Specific work assignments may vary and may change over time based on business needs, volume, and operational priorities.
Assignments are generally semi-routine in nature.
The UM Administration Coordinator 2 provides non-clinical support for policies and procedures ensuring the best and most appropriate treatment, care, or services for members.
This role may serve as a key point of contact for providers and members through inbound telephonic interactions, including responding to questions and supporting the intake and processing of utilization management requests. Associates must be comfortable working in a phone-based customer service environment, and some assignments may require the majority or entirety of the workday to be dedicated to inbound calls. Other assignments may include building and updating authorization cases, creating letters and other correspondence, processing and routing faxes, triaging shared mailboxes, reviewing and routing documentation, and completing other non-clinical administrative activities supporting the utilization management process. Associates are expected to demonstrate flexibility as work assignments may change based on business needs and operational priorities.
Decisions are typically focused on interpretation of area/department policy and process for completing assignments. Works within defined parameters to identify work expectations and quality standards but has some latitude over prioritization/timing and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
Success in this role requires the following:
Use your skills to make an impact
Required Qualifications
Preferred Qualifications
Work-At-Home Requirements
Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$40,000 - $52,300 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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.
About us
About Humana: 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. Learn more about what we offer at Humana.com and at CenterWell.com.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.