Partnership Operations Coordinator
SupabaseSalary not specified
Full Time
Junior (1 to 2 years)
Not SpecifiedCompensation
Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries
Requirements
- 1 or more years’ experience working in an administrative support capacity in a healthcare setting
- Excellent verbal and written communication skills
- Demonstrated attention to detail
- Ability to navigate process flows and follow procedure documents
- Working knowledge of MS Office including Word, Excel, Teams, and Outlook in a Windows based environment
- Ability to quickly learn new systems
- Must effectively manage personal responsibilities to ensure a professional work environment conducive to achieving performance goals
- Preferred Qualifications
- Proficient utilizing electronic medical record and documentation programs
- Prior experience with CGX and Genesys
- Prior experience with post-acute authorizations
- Prior experience in a metric driven environment
- Prior experience in the healthcare industry
- Proficient and/or experience with medical terminology and/or ICD-10 codes
- Prior member service or customer service telephone experience
- Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
Responsibilities
- Intercepting inbound calls and assisting facilities/providers in scheduling and coordinating Peer to Peer discussions
- Managing Humana Medical Directors' calendars
- Monitoring and decisioning authorizations
- Responding to provider inquiries regarding existing authorizations, and providing timely updates as needed via fax or phone calls, ensuring compliance with organizational policies and applicable federal regulations
- Maintaining high-quality standard and meeting monthly quality requirements
- Ability in maneuvering multiple systems simultaneously
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
What experience is required for the UM Administration Coordinator role?
The role requires 1 or more years of experience working in an administrative support capacity in a healthcare setting, excellent verbal and written communication skills, demonstrated attention to detail, ability to navigate process flows and follow procedure documents, and working knowledge of MS Office including Word, Excel, Teams, and Outlook.
What are the key responsibilities of this position?
Key responsibilities include intercepting inbound calls to assist facilities/providers in scheduling Peer to Peer discussions, managing Humana Medical Directors' calendars, monitoring and decisioning authorizations, responding to provider inquiries, maintaining high-quality standards, and maneuvering multiple systems simultaneously.
Is this a remote position or does it require office work?
This information is not specified in the job description.
What is the salary or compensation for this role?
This information is not specified in the job description.
What preferred qualifications will make my application stronger?
Preferred qualifications include proficiency utilizing electronic medical record and documentation programs, prior experience with CGX and Genesys, post-acute authorizations, metric-driven environments, healthcare industry, and experience with medical records.
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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