UM Non-Clinical Admin Coordinator 2 - 2nd Shift and Weekend Shift W/Shift Differential

Profile

Description

The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

This is considered a remote work at home position that requires applicants to live within a two, (2) hour driving distance, at maximum, from our main office:

Address: 11430 NW 20th Street Miami, FL 33172.

Responsibilities

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. Decisions are typically focused on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

This position requires 2nd shift and weekend shift schedules and will be compensated both hourly rate and shift differential.

Position 1: Monday & Tuesday 8:00 AM - 5:00 PM Saturday & Sundays 8:00 AM - 8:00 PM

Position 2: Thursday & Fridays 8:00 AM - 5:00 PM Saturday & Sunday 8:00 AM - 8:00 PM

Position 3: - Monday through Friday 2:00 PM -11:00 PM

Must have ability to work Nights, Weekends and Holidays as needed based on business.

Responsibilities:

Make outbound phone calls to UM Nurses, Hospitals, Skilled Nursing Facilities and other vendors to provide our members with a safe hospital discharge.

Document all calls and requests.

Search for Medicare and Medicaid Guidelines.

Process all incoming fax/emails request for services the same day.

Enter authorizations for all admission notifications.

Process discharge orders.

Return call for all voice messages the same day.

Support the UM Nurses.

Process provider and member letters including Variance days letter, Letter of Agreements, Approvals, Denials etc.

Mailing Letters .

Work with UM Nurses, Pharmacy, Medical Directors and other Departments to provide our members with a safe discharge.

Assist the UM Administration Coordinator 2 team with various clerical and administrative tasks as necessary.

Participate in special projects as assigned by your Supervisor or Manager.

Required Qualifications

Minimum 1 year administrative or technical support experience.

Excellent verbal and written communication skills.

Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems.

Schedule: Department Shifts Eastern Standard Time

This position requires 2nd shift and weekend shift schedules and will be compensated both hourly rate and g shift differential.

Position 1: Monday & Tuesday 8:00 AM - 5:00 PM Saturday & Sundays 8:00 AM - 8:00 PM

Position 2: Thursday & Fridays 8:00 AM - 5:00 PM Saturday & Sunday 8:00 AM - 8:00 PM

Position 3: - Monday through Friday 2:00 PM -11:00 PM

Must have ability to work Nights, Weekends and Holidays as needed based on business.

Work at Home Requirement:

Must have accessibility to high-speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 25Mx10M.

Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Preferred Qualifications

Proficient utilizing documentation programs

Proficient and/or experience with medical terminology and/or ICD-10 codes

Bachelor's Degree in Business, Finance or a related field

Prior member service or customer service telephone experience desired

Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

Additional Information

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

Interview Format

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

You will be able to respond to the recruiters preferred response method via text, video or voice technologies If you are selected for a screen, you may 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. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Humana Covid Practices

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com