The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
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
- Will handle requests from the provider side (doctors, primary care physicians, specialists, etc.).
- Decisions are typically focused on interpretation of area/department policy and methods 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.
- 3+ years of customer service experience in healthcare or medical field
- Proficient and/or experienced with medical terminology and/or ICD-10 codes
- 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
- A dedicated home office space, with a locked door, lacking ongoing interruptions to protect member PHI / HIPAA information
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
- Schedule may be Monday-Friday or Tuesday - Saturday, rotating weekends and overtime, pending business needs
- Bachelor's Degree
- Proficient utilizing electronic medical record and documentation programs
- Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
- 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 of 10x1 (10mbs download x 1mbs upload) is required
In order to support the CDC recommendations on social distancing and reduce health risks for associates, members and public health, Humana is deploying virtual and video technologies for all hiring activities. This position may be subject to temporary work at home requirements for an indefinite period of time. These requirements include access to a personal computing device with a camera, a minimum internet connection speed of 10m x 1m, and a dedicated secure home workspace for interview or work purposes. Humana continues to monitor the situation, and will adjust service levels as the coronavirus situation evolves. The following changes are temporary and will be evaluated frequently with the goal of returning to normal operations as soon as possible. Your Talent Acquisition representative will advise on the latest recommendations to protect your health and wellbeing during the hiring process. #ThriveTogether #WorkAtHome
For this job, associates are required to be fully COVID vaccinated (preferred) 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 ahealthcarecompany 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 vaccinationor commit totesting protocolsOR
• Provide proof of applicable exemption including any required supporting documentation
Medical, religious,stateand remote-only work exemptions areavailable.
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.Scheduled Weekly Hours
This job has expired.