UM Administration Coordinator

San Antonio, Texas, United States

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Not SpecifiedCompensation

Entry Level & New Grad, Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Candidates must possess strong attention to detail, excellent typing and computer navigation skills, and the ability to manage multiple competing priorities using various computer applications simultaneously. A passion for improving consumer experiences, administrative or technical support experience, and excellent verbal and written communication skills are required. Proficiency in MS Office (Word, Excel, Outlook) within a Windows environment and the ability to learn new systems quickly are essential. Candidates must also have a reliable internet service with a minimum download speed of 25 Mbps and an upload speed of 10 Mbps, using DSL or Cable connection (satellite is not allowed). An Associate or Bachelor's degree is preferred, along with previous contact center or customer service experience, healthcare experience, proficiency with medical terminology and/or ICD-10 codes, and experience with Utilization Review and/or Prior Authorization.

Responsibilities

The UM Administration Coordinator 1 contributes to the administration of utilization management by performing basic administrative, clerical, operational, customer support, and computational tasks. This role provides non-clinical support for policies and procedures to ensure the best and most appropriate treatment, care, and services for customers. Decisions are made within defined parameters, working under close supervision and established guidelines with minimal opportunity for deviation.

Skills

Attention to detail

Typing

Computer navigation

Prioritization

MS Office

Word

Excel

Outlook

Windows

Electronic medical record systems

Medical terminology

ICD-10 codes

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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