Utilization Management Administration Coordinator - Remote

Profile

Job Information

Humana

Utilization Management Administration Coordinator - Remote

in

Pittsburgh

Pennsylvania

Description

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

Responsibilities

Humana is seeking a dedicated, compassionate, and experience - Utilization Management Administration Coordinator

- who is interested in growing with the company and being part of something great!

Location

: This is a REMOTE - Work from Home

- position.

Humana is a Fortune 60 healthcare company with a history of successful innovation and reinvention, with over 50 years as a proven leader and innovator in the health and wellness industry. A passionate emphasis on people, choice, well-being, and innovation guide our business and culture. We're not just a health insurance company: our diverse lines of business position us to serve millions of people with a wide range of needs, including seniors, military members, and self-employed individuals.

Humana, a market leading Medicare Advantage and Medicare Prescription drug businesses, is continuing to grow with our continued investment in developing a robust integrated care delivery model that integrates insurance with high value health care services, such as Primary Care, Home Care, and Pharmacy. Humana is consistently recognized as a top place to work in healthcare, especially in areas of Diversity and Inclusion.

Vaccine Policy:

For this job, associates are required to be fully COVID vaccinated or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

Provide proof of full vaccination OR

Commit to weekly testing, following all CDC protocols, OR

Provide documentation for a medical or religious exemption consideration.

This policy will not supersede state or local laws. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.

Utilization Management RN Role Overview

The UM Administration Coordinator provides support for our clinicians to improve the quality and timing for how our seniors access they care they need. The UMAC's on our team provide a vital function from beginning to end in our process to help guide our patients to access the care they need. These talented associates are able to multi task from many work streams, coordinating the intake of necessary medical documents, completing letter templates, and providing overall support for our nurses and physicians. The UMAC is essential for our team in achieving the day to day goals and frequently assists in guiding patients to the care they need. These associates are able to follow specific workflows with little guidance and collaborate with their team and leaders when needed. Utilizing the role training and a high degree of emotional intelligence these associates continue to evolve into active contributors to our team helping us to further improve how we can help those patients we serve.

Required Qualifications

High School Diploma

2 or more years 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

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

Preferred Qualifications

Proficient utilizing electronic medical record and 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

Utilization Management RN Working hours

Scheduled 40 hours per week

Monday to Friday 8AM-5PM

When travel is required; Cost and/or mileage is reimbursed

Being a part of the Humana team gives you benefits that include

We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, weeks of paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more.

Alert

: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana's secure website.

Interview Format

To enhance our hiring and decision-making ability. Modern Hire Text 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 first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire text interview. In this interview, you will read to a set of interview questions and you will provide text responses to each question. You should anticipate this interview to take about 15 minutes. Your text interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Language Proficiency Testing

Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. See Additional Information on testing. ​ Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Equal Employment Employer

Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin, veterans and all of the other fascinating characteristics that make us each uniquely wonderful.

Scheduled Weekly Hours

40

Company info

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