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The Utilization Management (UM) Coordinator contributes to administration of UM. The UM Coordinator performs varied activities and moderately complex administrative, operational, and Enrollee support assignments. You will performs computations and typically works on semi-routine assignments. POSITION RESPONSIBILITIES:
Provide nonclinical support for the policies and procedures, ensuring best and most appropriate treatment, care, or services for our Enrollees
Assist Providers with discharge planning for Enrollees with inpatient stay or outpatient physical health
Work on special projects with the clinical team
Complete Provider-facing responsibilities
Use your skills to make an impact
Required Qualifications
Must reside in Oklahoma
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 improving consumer experiences
Preferred Qualifications
Proficient using electronic medical record and documentation programs
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
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
Additional Information
Must be able to work occasional Saturday rotations
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.
