Utilization Management Administration Coordinator – SNF

🕒 July 29

🇺🇸 United States – Remote

💵 $40k - $52.3k / year

⏰ Full Time

🟢 Junior

🖥️ Administration

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 53%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Provide non-clinical support for policies ensuring appropriate treatment, care, or services for members • Manage NLPs for chart reviews for the nursing team • Build and pend authorizations for review • Perform inbound and outbound calls with providers and members to verify clinical information, discharge dates, and admission status • Document completed calls and attach received clinical information • Request clinical information from providers and facilities • Create written correspondence • Create and distribute determination letters • Collaborate with multiple roles, departments, providers, and team members • Work within defined parameters to meet work expectations and quality standards

🎯 Requirements

• 1+ years' experience working in an administrative support capacity • Prior professional experience of Microsoft Word, Outlook and Excel with the ability to type and enter data • Ability to learn new systems and proficiency to advanced proficiency • Experience with Utilization Review or Prior Authorization within a managed care organization preferred • Proficient using electronic medical record and documentation programs preferred • Experience with medical terminology or ICD-10 codes preferred • Prior member service or customer service telephone experience preferred • Experience with SNF or Home Health preferred • Prior experience with CGX, SRO and HCHB preferred • Prior experience in a metric driven environment preferred • Prior experience in the healthcare industry preferred • Minimum download speed of 25 Mbps and upload speed of 10 Mbps • Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Internet expense payment for employees who live and work from Home in California, Illinois, Montana, or South Dakota • Telephone equipment appropriate to meet business requirements • Fully remote work arrangement • Occasional travel to Humana offices for training or meetings may be required