Job Description

Description

The UM Administration Coordinator provides clerical support for the department. We are the beginning, middle and end of processes for utilization management. This role partners with leadership, Medical Directors, Nurses and with other team members.

Responsibilities

Achieve your best at Humana. Join Us! The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members.

Key Responsibilities:

• Attaching faxes for chart reviews for the nursing team
• Answering departmental phones as assigned
• Make outbound calls to engage providers to verify clinical information/discharge date and admission status
• Document calls and attach clinical information received
• Request clinical information from providers/facilities
• Create and send out written correspondence
• Ability to multitask and prioritize
• Creation and distribution of determination letters
• Collaborate with multiple roles/departments/providers/team members

** REMINDER: ATTACH A COPY OF YOUR RESUME**

Required Qualifications

• 1 or more years\xe2\x80\x99 experience working in an administrative support capacity in the healthcare industry
• Prior professional experience of Microsoft Word, Outlook and Excel with the ability to type and enter data accurately, as well as the ability to quickly learn new systems (proficient to advanced)
• Must meet Humana\'s Work at Home policy listed in additional information
• Prior experience in a metric driven environment

Preferred Qualifications

• Proficient utilizing electronic medical record and documentation programs
• Proficient 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

Additional Information

• Hours for this role are: Monday \xe2\x80\x93 Friday, 8 hour shift will fall between the hours of 7:00am-7:00pm EST a Saturday rotation may be required based on a business need

Virtual Pre-Screen:

As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a Modern Hire interview. In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes.

Work at Home Connectivity Requirements

To ensure Home or Hybrid Home/Office associates\xe2\x80\x99 ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
• Wireless, Wired Cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
• Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state 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.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana\xe2\x80\x99s secure website.

If you have additional questions regarding this role posting, please send them to the Ask A Recruiter by visiting go/Buzz and searching Ask A Recruiter or email . Please be sure to provide the requisition number so we may be able to research your request quicker.

This is a remote position

#LI-Remote

Scheduled Weekly Hours

40

Humana