UM Administration Coordinator 2

Employment Type: Full-time

Position Overview

Become a part of our caring community and help us put health first. The UM Administration Coordinator 2 contributes to the administration of utilization management. This role performs basic administrative, clerical, operational, customer support, and computational tasks, working on semi-routine and patterned assignments. The UM Administration Coordinator 2 provides non-clinical support, following established policies and procedures to ensure the best and most appropriate treatment, care, or services for members.

Key Responsibilities

• Prepares and forwards authorization requests to clinical review.
• Works within defined parameters to identify work expectations and quality standards, with some autonomy over prioritization/timing, and works under minimal direction.
• Completes inbound and outbound provider calls to answer UM-related questions and prepare authorization requests for clinical review.
• Documents calls and attaches clinical information to the member’s medical record.
• Creates and sends out written correspondence.
• Ability to multitask and prioritize.
• Collaborates with multiple roles, departments, providers, and team members.
• Uses skills to make an impact.

Requirements

• Minimum 1 year of healthcare or clinical experience (working for a health plan, organization, or provider).
• Excellent verbal and written communication skills.
• Working knowledge of MS Office, including Word, Excel, and Outlook, in a Windows-based environment.
• Ability to quickly learn new systems and troubleshoot basic technical difficulties in a remote environment.

Preferred Qualifications

• Proficient utilizing electronic medical record and documentation programs.
• Prior member service or customer service telephone experience.
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
• Clerical support background in a healthcare environment.
• Familiarity with medical terminology and/or ICD-10 codes.
• CNA or Medical Assistant background is a plus.

Additional Information

• Workstyle: Remote work at home.
• Location: Multiple Locations.
• Training Schedule: Must be able to attend training schedule. Monday through Friday; 8:00 AM - 5:00 PM Central/Eastern Time (based on residence).
• Work Schedule: The department has multiple schedules available.
• Travel: Minimal travel for office meetings 1-2 times annually.

Work from Home Guidance

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended.

• Wireless, wired cable, or DSL connection is suggested.

• Satellite, cellular, and microwave connections can be used only if approved by leadership.

• Associates who live and work from Home in the states of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Montage Voice to enhance our hiring and decision-making ability. Modern Hire Voice allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

If you are selected for a first-round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a Modern Hire Voice interview.