Description

The UM Administration Coordinator 4 contributes to administration of utilization management. The UM Administration Coordinator 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.

Responsibilities

The UM Administration Coordinator 4 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members.

• Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals,

• and often oversees work of others and/or is the primary administrative owner of a main process, program, product or technology.

• Works within broad guidelines with little oversight.

Required Qualifications

• Minimum 2 years administrative experience including high call volume, and heavy front/back-office support.
• Minimum 1 year Utilization Administrative experience
• Excellent verbal and written communication skills
• Proven ability as a mentor, trainer, quality coaching, or preceptor
• Proven ability to prioritize tasks and manage timelines to meet business needs
• Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
• Proficient utilizing authorizations, pre-authorizations documentation and process programs
• Proficient and/or experience with medical terminology and/or ICD-10 codes

Preferred Qualifications

• Associate's or Bachelor's degree
• Prior member service or customer service telephone experience desired
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

Workstyle: KY Based - Hybrid - Minimum 1 day a week in Louisville KY Corporate office / OK Based - Remote

Location: Must reside within reasonable commuting distance to Louisville, KY or Remote, OK

Schedule:

• Must be willing to work an 8-hour shift Monday through Friday 8:00 AM - 8:00 PM Eastern time zone
• Rotating holidays and possible weekend coverage
• Schedule will be provided in more detail by the department
• Training/Start Date: January 29th 2024

Work at Home Requirements

• 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.

Additional Information

Our Benefits

Health benefits effective day 1. Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

• Paid time off, holidays, volunteer time and jury duty pay, Recognition pay.
• 401(k) retirement savings plan with employer match.
• Tuition assistance, Scholarships for eligible dependents.
• Parental and caregiver leave.
• Employee charity matching program.
• Network Resource Groups (NRGs).
• Career development opportunities.

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire/Montage, 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.

Social Security Task

#LI-KK1

#LI-Remote

#LI-Hybrid

Scheduled Weekly Hours

40