UM Administration Coordinator

Humana • Chittenden, VT

3d • $40,000 - $52,300 • Remote

About The Position

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 typically focus on interpretation of area/department policy and methods for completing assignments. You will work within defined parameters to identify work expectations and quality standards, but have some latitude over prioritization/timing, and works under minimal direction. You will follow standard policies and practices that allow for some opportunity for interpretation/deviation and independent discretion.
Provide Long- Term Services and Supports (LTSS) UM support by managing shared mailboxes and entering data into work queues and/or clinical documentation systems.
Mail letters/educational material, prepare documents for LTSS UM (Utilization Management) reviewers and Medical Directors, and perform other administrative responsibilities as assigned.
Ensure the timely and correct submission of state-required deliverables.
Work with care coordinators and other internal and external stakeholders who guide members and their families toward and facilitate interaction with resources appropriate for care and well-being.
Perform varied activities of clerical activities including perform computations, reporting data, tracking data, pulling reports and monitoring/managing email.
Typically work on semi-routine assignments that are subject to change.
May make, receive, and soft transfer calls to and from members, member's families and providers.
Ensure timely communication and follow up occurs with care management.

Requirements

• Must reside in Michigan.
• One (1) or more years of administrative experience in a healthcare environment.
• Strong verbal and written communication skills to support stakeholder communication and coordination.
• Working knowledge of Microsoft Word, Excel, and Outlook in a Windows-based environment and the ability to learn new software and systems.

Nice To Haves

• Experience with LTSS programs.
• Experience with LTSS Utilization Review and/or Prior Authorization, preferably within a managed care organization.
• Proficient using electronic medical record and documentation programs.
• Proficient or experienced with medical terminology and/or ICD-10 codes.
• Prior member service or customer service telephone experience.

Responsibilities

• Provide Long- Term Services and Supports (LTSS) UM support by managing shared mailboxes and entering data into work queues and/or clinical documentation systems.
• Mail letters/educational material, prepare documents for LTSS UM (Utilization Management) reviewers and Medical Directors, and perform other administrative responsibilities as assigned.
• Ensure the timely and correct submission of state-required deliverables.
• Work with care coordinators and other internal and external stakeholders who guide members and their families toward and facilitate interaction with resources appropriate for care and well-being.
• Perform varied activities of clerical activities including perform computations, reporting data, tracking data, pulling reports and monitoring/managing email.
• May make, receive, and soft transfer calls to and from members, member's families and providers.
• Ensure timely communication and follow up occurs with care management.

Benefits

• medical
• dental
• vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed