Description

The Utilization Management (UM) Coordinator contributes to administration of UM. The UM Coordinator performs varied activities and moderately complex administrative, operational, and Enrollee support assignments. The individual in this role performs computations and typically works on semi-routine assignments.

Responsibilities

RESPONSIBILITIES:

· Provides nonclinical support for the policies and procedures, ensuring best and most appropriate treatment, care, or services for our Enrollees

· Assists Providers with discharge planning for Enrollees with inpatient stay or outpatient physical health

· Works on special projects with the clinical team

· Completes Provider-facing responsibilities

REQUIRED QUALIFICATIONS:

- High school diploma or equivalent

- 1+ yrs of experience in a healthcare environment.

- Knowledgeable with behavioral health resources in Oklahoma

- Proficient using electronic health record and documentation programs

- Proficient or Intermediate experience with medical terminology or ICD-10 codes

PREFERRED QUALIFICATIONS:

- Experience with enrollee services or customer service

- Associate or bachelor's degree in healthcare, business, finance, or related field

- Experience working in Medicaid or Medicare

Work at Home/Hybrid Guidance:
To 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 suggested
Satellite, cellular and microwave connection can be used only if approved by leadership. Associates 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 expense. Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Scheduled Weekly Hours

40