Behavioral Health Utilization Management Coordinator

🔥 0 minutes ago

⚜️ Louisiana, Ohio, +1 more states – Remote

⚜️ Louisiana – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote

💵 $40k - $52.3k / year

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

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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

• Contribute to administration of utilization management • Perform basic administrative, clerical, operational, customer support, and computational tasks • Provide non-clinical support according to established policies and procedures • Prepare and forward authorization requests for clinical review • Complete inbound and outbound provider calls to answer utilization-management questions • Prepare authorization requests for clinical review • Document calls and attach clinical information to members’ medical records • Create and send written correspondence • Multitask and prioritize work • Collaborate with multiple roles, departments, providers, and team members • Attend occasional Humana office meetings, training, or other meetings as business needs require

🎯 Requirements

• Minimum 1 year administrative experience in healthcare field • Excellent verbal and written communication skills • Working knowledge of MS Office including Word, Excel, and Outlook • Experience in a Windows-based environment • Ability to quickly learn new systems • Ability to troubleshoot and resolve basic technical difficulties in a remote environment • Must be able to attend training Monday through Friday, 8:00 AM–5:00 PM Central Time • Must work Monday through Friday, 8:00 AM–5:00 PM Central Time, with rotating holidays and weekends • Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information • Self-provided internet with minimum 25 Mbps download and 10 Mbps upload speeds • Proficiency with electronic medical record and documentation programs preferred • Prior member service or customer service telephone experience desired • Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization • Clerical support background in a healthcare environment • Familiarity with medical terminology and/or ICD-10 codes • Current or former specified Louisiana Health Department personnel are ineligible unless separated from LDH for two or more years

🏖️ Benefits

• Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Remote work at home • Minimal/occasional travel for office meetings, training, or meetings (1–2 times annually as business needs require)