Humana

UM Administration Coordinator 2

Virginia, United States

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Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

Candidates should possess health care and/or health administrative experience, excellent verbal and written communication skills, and working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment. They should also demonstrate an ability to quickly learn new systems and ideally have prior member service or customer service telephone experience. A Bachelor’s degree in Business, Finance, or a Health-related field is preferred.

Responsibilities

The UM Administration Coordinator 2 contributes to the administration of LTSS utilization management by providing non-clinical support for policies and procedures, ensuring best and most appropriate treatment, care, or services for members. They manage shared mailboxes, enter data into work queues, mail letters/educational material, research unable to contact members, and complete other administrative functions as assigned. The role involves ensuring the timely and correct submission of Commonwealth-required deliverables, researching alternative contact information, contacting members to engage them in care management programs, and supporting inbound call escalations. Additionally, the coordinator provides non-clinical support for the assessment and evaluation of members’ needs and requirements, interacts with Service Coordinators and Field Care Managers, performs varied clerical activities including reporting data and tracking data, and may make, receive, and soft transfer calls.

Skills

Administrative support
Data entry
Customer service
Communication
Research
Reporting
Data tracking
Email management
Care management support

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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