Humana

UM Administration Coordinator

Florida, United States

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

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.

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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