[Remote] UM Administration Coordinator at Humana

Oklahoma, United States

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Not SpecifiedCompensation

Entry Level & New Grad, Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Medicaid, MedicareIndustries

Requirements

Must reside in the state of Oklahoma
One (1) or more years of experience working in a healthcare environment
Proficient or Intermediate experience with medical terminology or ICD-10 codes
Proficient using electronic health record and documentation programs

Responsibilities

Provides nonclinical support for the policies and procedures, ensuring best and most appropriate treatment, care, or services for Enrollees
Assists Providers with discharge planning for Enrollees with inpatient stay or outpatient physical health
Works on special projects with the clinical team
Performs varied activities and moderately complex administrative, operational, and Enrollee support assignments
Performs computations and typically works on semi-routine assignments

Skills

medical terminology

ICD-10

electronic health records

EHR

utilization management

discharge planning

customer service

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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