- Dental insurance
- Health insurance
- 401(k) matching
- Tuition reimbursement
- Technical support
- Microsoft Excel
- Utilization review
- Communication skills
- Bachelor’s degree
- High school diploma or GED
Humana is seeking a dedicated, compassionate, and experience – Utilization Management Administration Coordinator – who is interested in growing with the company and being part of something great!
Location: This is a REMOTE – Work from Home – position.
Humana is a Fortune 60 healthcare company with a history of successful innovation and reinvention, with over 50 years as a proven leader and innovator in the health and wellness industry. A passionate emphasis on people, choice, well-being, and innovation guide our business and culture. We’re not just a health insurance company: our diverse lines of business position us to serve millions of people with a wide range of needs, including seniors, military members, and self-employed individuals.
Humana, a market leading Medicare Advantage and Medicare Prescription drug businesses, is continuing to grow with our continued investment in developing a robust integrated care delivery model that integrates insurance with high value health care services, such as Primary Care, Home Care, and Pharmacy. Humana is consistently recognized as a top place to work in healthcare, especially in areas of Diversity and Inclusion.
For this job, associates are required to be fully COVID vaccinated, including booster.
If progressed to offer, you will be required to:
Provide proof of full vaccination (including booster) OR
Wear masks at all times (except while eating or drinking), OR
Provide documentation for a medical or religious exemption consideration.
This policy will not supersede state or local laws. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.
Utilization Management Administrative Coordinator Role Overview:
Provides support for our clinicians to improve the quality and timing for how our seniors access they care they need
Provide beginning to end support to help guide our patients to access the care they need
Responsible for multi tasking from many work streams, coordinating the intake of necessary medical documents, completing letter templates, and providing overall support for our nurses and physicians
Essential in achieving team’s day to day goals
Follows specific workflows with little guidance and collaborate with their team and leaders when needed
Utilizes the role training and a high degree of emotional intelligence to evolve into active contributors to our team helping us to further improve how we can help those patients we serve
High School Diploma
2 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
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
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
Utilization Management RN Working hours:
Scheduled 40 hours per week
Monday to Friday 8AM-5PM
When travel is required; Cost and/or mileage is reimbursed
Being a part of the Humana team gives you benefits that include:
We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, weeks of paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more.
Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.
To enhance our hiring and decision-making ability. Modern Hire Text allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email correspondence inviting you to participate in a Modern Hire text interview. In this interview, you will read to a set of interview questions and you will provide text responses to each question. You should anticipate this interview to take about 15 minutes. Your text interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Language Proficiency Testing:
Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. See Additional Information on testing. Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.
Equal Employment Employer:
Humana is more than an equal opportunity employer, Humana’s dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin, veterans and all of the other fascinating characteristics that make us each uniquely wonderful.
Scheduled Weekly Hours