UM Administration Coordinator

Florida, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Candidates should have 2 or more years of administrative or technical support experience, proficiency in MS Office including Word, Excel, and Outlook, and an ability to quickly learn new systems. Experience utilizing electronic medical record and/or documentation programs is required, along with an ACHA Level II Background Check.

Responsibilities

The UM Administration Coordinator will provide non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. They will regularly exercise discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques. The role involves utilizing electronic medical record and/or documentation programs, monitoring and interpreting changes in employment legislation, and developing HR policies to ensure compliance. The coordinator will also conduct audits, deliver training, and advise management on HR-related risk mitigation strategies, and may occasionally travel to Humana’s offices for training or meetings.

Skills

MS Office

Word

Excel

Outlook

Electronic medical record

Documentation programs

Medical terminology

ICD-10 codes

Utilization Review

Prior Authorization

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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