Utilization Management Physician Reviewer
Blank StreetFull Time
Senior (5 to 8 years)
Key technologies and capabilities for this role
Common questions about this position
After training, you must be available to work 4 days a week for 10-hour shifts during 6am–7pm EST and are required to work at least one weekend day (Saturday or Sunday).
Minimum 1 year of customer service experience with de-escalation skills, excellent verbal and written communication, attention to detail, ability to follow procedures, proficient keyboarding, multitasking across systems, quick learning for new tech, Microsoft Office proficiency, and a suitable designated workspace.
This is a work-at-home role requiring a designated workspace with a closed door that minimizes distractions and meets leadership approval, plus internet with at least 25 Mbps download and 10 Mbps upload speeds.
Proficiency in electronic medical records, experience with Utilization Review or Prior Authorization in managed care, knowledge of medical terminology or ICD-10 codes, and bilingual fluency in English and Spanish.
This information is not specified in the job description.
Health insurance provider for seniors and military
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.