UM Administration Coordinator

UM Administration Coordinator 2Become a part of our caring community and help us put health first. 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. Decisions are typically focus 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.Key ResponsibilitiesResponsible for intercepting inbound calls and assisting facilities/providers in scheduling and coordinating Peer to Peer discussionsManaging Humana Medical Directors' calendarsMonitoring and decisioning authorizationsResponding to provider inquiries regarding existing authorizations, and providing timely updates as needed via fax or phone calls, ensuring compliance with organizational policies and applicable federal regulations.Maintaining high-quality standard and meeting monthly quality requirementsAbility to maneuver multiple systems simultaneouslyCore CompetenciesCommunicate ideas and updates clearly to team members, actively listen to feedback and concerns, and facilitate open, honest dialogue.Collaborate and contribute effectively to team projects and goals, supporting colleagues and resolving issues that impact the team.Share knowledge, work effectively with cross-functional teams, and coordinate tasks and responsibilities among team members.Required Qualifications1 or more years experience working in an administrative support capacity in a healthcare settingExcellent verbal and written communication skillsDemonstrated attention to detailAbility to navigate process flows and follow procedure documentsWorking knowledge of MS Office including Word, Excel, Teams, and Outlook in a Windows based environment and an ability to quickly learn new systemsMust effectively manage personal responsibilities to ensure a professional work environment conducive to achieving performance goalsPreferred QualificationsProficient utilizing electronic medical record and documentation programsPrior experience with CGX and GenesysPrior experience with post-acute authorizationsPrior experience in a metric driven environmentPrior experience in the healthcare industryProficient and/or experience with medical terminology and/or ICD-10 codesPrior member service or customer service telephone experience desiredExperience with Utilization Review and/or Prior Authorization, preferably within a managed care organizationWork-At-Home RequirementsTo ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggestedSatellite, cellular and microwave connection can be used only if approved by leadershipAssociates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expenseHumana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/jobWork from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA informationAdditional InformationWork hours are Monday-Friday 7am-7pm EST (Your 8-hour shift will fall within this timeframe)Overtime available based upon business needsWeekend and/or holiday coverage possible for this roleTravel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours40Pay Range$40,000 - $52,300 per yearDescription of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers 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 while also knowing your life extends outside of work. Among our benefits, Humana provides 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.Application Deadline11-20-2025About UsHumana 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.Equal Opportunity EmployerIt is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.