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Role Description

The UM Administration Coordinator 2 supports the administration of utilization management by performing a variety of moderately complex administrative, operational, and customer service tasks. This role includes conducting calculations and data processing as part of its responsibilities. Assignments are generally semi-routine in nature.

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 process 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.

Success in this role requires the following:

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
• Excellent organizational and time management skills.
• Technical savvy and ability to navigate multiple systems and screens while working cases.
• Collaboration skills to effectively interact with multiple parties both internal and external.
• An understanding of department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Ability to make decisions regarding your own work methods, occasionally in ambiguous situations, and with minimal direction receiving guidance where needed.
• Ability to follow established guidelines, processes, and procedures.

Work-At-Home Requirements:

• Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role).
• A minimum standard speed for optimal performance is 25mbs download x 10mbs upload is required.
• A dedicated office space lacking ongoing interruptions so you can meet productivity requirements, and to protect member PHI / HIPAA information.

Qualifications

• 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.
• Be able to work between the hours of 8am to 8pm EST.
• Hours may include rotational weekend work.

Requirements

• 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.
• Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Benefits

• Humana, Inc. and its affiliated subsidiaries offer 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.
• 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.

Company Description

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.