UM Administration Coordinator

Position Overview

• Location Type: Home (Remote with occasional office visits)
• Job Type: Full-time
• Salary: $40,000 - $52,300 per year

Humana Healthy Horizons in Florida is seeking a UM Administration Coordinator to contribute to the administration of utilization management. This role performs advanced administrative, operational, and customer support duties requiring independent initiative and judgment. The UM Administration Coordinator provides non-clinical support for policies and procedures, ensuring the best and most appropriate treatment, care, or services for members. Decisions are typically focused on methods, tactics, and processes for completing administrative tasks and projects. The role regularly exercises discretion and judgment in prioritizing requests and interpreting/adapting procedures, processes, and techniques, working under limited guidance due to prior experience and depth of knowledge.

Requirements

• 2 or more years of administrative or technical support experience.
• Proficiency in MS Office (Word, Excel, Outlook) in a Windows-based environment.
• Ability to quickly learn new systems.
• Experience utilizing electronic medical record and/or documentation programs.
• ACHA Level II Background Check is required.
• Must reside in the state of Florida.
• Ability to work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information.

Preferred Qualifications

• Prior member service or customer service telephone experience.
• Proficiency and/or experience with medical terminology and/or ICD-10 codes.
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.

Work Environment & Schedule

• Workstyle: Home (Remote, with potential need to use Humana office space for collaboration/face-to-face needs).
• Work Location: Must reside in the state of Florida.
• Typical Work Days/Hours: Monday – Friday, 8:30 am – 5:00 PM EST.
• Internet Requirements: Minimum download speed of 25 Mbps and upload speed of 10 Mbps recommended. Wireless, wired cable, or DSL connection suggested. Satellite, cellular, and microwave connections may be used only if approved by leadership. (Note: Specific internet support is provided for employees in California, Illinois, Montana, or South Dakota).
• Equipment: Humana will provide appropriate telephone equipment.

Application Process

• As part of the hiring process, HireVue will be used for interviewing to enhance hiring and decision-making abilities.

Travel

• Occasional travel to Humana's offices for training or meetings may be required.

Company Information

Humana, Inc. and its affiliated subsidiaries offer competitive benefits that support whole-person well-being, encouraging personal wellness and smart healthcare decisions.