UM Administration Coordinator
About The Position
The Utilization Management (UM) Coordinator contributes to the administration of UM by performing varied, moderately complex administrative, operational, and Enrollee support assignments. The role performs computations and typically handles semi-routine assignments. It provides nonclinical support related to policies and procedures intended to ensure the best and most appropriate treatment, care, or services for Enrollees, assists Providers with discharge planning for Enrollees with inpatient stays or outpatient physical health, works on special projects with the clinical team, and completes Provider-facing responsibilities. This is a remote position requiring residence in Oklahoma. Occasional travel to Humana offices for training or meetings may be required, as may occasional Saturday rotations. Work-at-home employees must provide internet service with at least 25 Mbps download and 10 Mbps upload speeds and work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information.
Requirements
- Must reside in Oklahoma.
- At least 1 year of administrative or technical support experience.
- Working knowledge of MS Office, including Word, Excel, and Outlook, in a Windows-based environment, and ability to quickly learn new systems.
- Passion for contributing to an organization focused on improving consumer experiences.
Nice To Haves
- Proficiency using electronic medical record and documentation programs.
- Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
- Proficiency 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.
Responsibilities
- Provide nonclinical support for policies and procedures to ensure the best and most appropriate treatment, care, or services for Enrollees.
- Assist Providers with discharge planning for Enrollees with inpatient stays or outpatient physical health.
- Work on special projects with the clinical team.
- Complete Provider-facing responsibilities.
- Perform computations and moderately complex administrative, operational, and Enrollee support assignments.
Benefits
- Medical, dental, and vision benefits.
- 401(k) retirement savings plan.
- Paid time off, company holidays, and personal holidays.
- Paid parental and caregiver leave.
- Short-term and long-term disability insurance.
- Life insurance.
- Other opportunities supporting personal wellness and healthcare decisions.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
