Description

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.

Responsibilities

Achieve your best at Humana. Join Us! 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 Responsibilities:

• Attaching faxes for chart reviews for the nursing team
• Answering departmental phones as assigned
• Make outbound calls to engage members and/or providers to verify clinical information/discharge date and admission status
• Document calls and attach clinical information received
• Request clinical information from providers/facilities
• Create and send out written correspondence
• Ability to multitask and prioritize
• Collaborate with multiple roles/departments/providers/team members

Required Qualifications

• 1 or more years of administrative support experience
• Excellent verbal and written communication skills
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
• Strong attention to detail and excellent organizational skills
• Comprehensive knowledge of Microsoft Word, Outlook and Excel with the ability to type and enter data accurately, as well as the ability to quickly learn new systems

Preferred Qualifications

• Proficient utilizing electronic medical record and documentation programs
• Proficient and/or experience with medical terminology and/or ICD-10 codes
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

Work-At-Home Requirements

• WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required
• Satellite and Wireless Internet service is NOT allowed for this role
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Additional Information

• Hours for this role are: Monday-Friday 7am-7pm EST based on business needs, with a Saturday rotation. (The candidate's 8 hour shift will fall between this timeframe)

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Scheduled Weekly Hours

40