UM Administration Coordinator II

CenterWell • Arlington, TX

1d • Remote

About The Position

Become a part of our caring community Utilization Management Administration Coordinator II , non-clinical, supports the UM operations by performing administrative and clerical tasks, rather than clinical duties. This role focuses on the administrative aspects of managing healthcare utilization, ensuring efficient and effective processes within the UM program. Key Responsibilities of a Non-Clinical UM Coordinator: Intake and Notification: Handling initial requests for services, gathering necessary information, and communicating with relevant parties. Prior Authorization Support: Assisting with the prior authorization process by gathering information, preparing documentation, and tracking requests. Document Management: Maintaining and organizing patient records, ensuring accurate and up-to-date information is available for reviews. Communication: Facilitating communication between healthcare providers, patients, and other stakeholders regarding UM processes. Data Entry and Reporting: Accurately entering data into systems, generating reports, and tracking key performance indicators related to UM activities. Letter Management: Managing the generation and distribution of various letters related to UM decisions and processes. General Administrative Support: Providing general administrative support to the UM team, including scheduling meetings, managing calendars, and preparing presentations. In essence, the non-clinical UM Coordinator acts as a vital link in the UM process, ensuring smooth workflows and effective communication while handling the administrative side of utilization management. Use your skills to make an impact

Requirements

• 1 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
• 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 10Mx1M
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Nice To Haves

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

Responsibilities

• Intake and Notification: Handling initial requests for services, gathering necessary information, and communicating with relevant parties.
• Prior Authorization Support: Assisting with the prior authorization process by gathering information, preparing documentation, and tracking requests.
• Document Management: Maintaining and organizing patient records, ensuring accurate and up-to-date information is available for reviews.
• Communication: Facilitating communication between healthcare providers, patients, and other stakeholders regarding UM processes.
• Data Entry and Reporting: Accurately entering data into systems, generating reports, and tracking key performance indicators related to UM activities.
• Letter Management: Managing the generation and distribution of various letters related to UM decisions and processes.
• General Administrative Support: Providing general administrative support to the UM team, including scheduling meetings, managing calendars, and preparing presentations.

Benefits

• Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level