Care Management Support Assistant

🔥 16 hours ago

🇺🇸 United States – Remote

💵 $39k - $49.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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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

• Process referrals from Military Treatment Facilities and civilian providers for the Autism Care Demonstration program • Recognize ACD-specific assessments and treatment plans • Pend referrals and authorizations for review • Coordinate authorizations with Autism Services Navigators and Utilization Management • Answer questions from associates and MTF/civilian providers and obtain additional information to complete referrals • Perform data entry into the medical management system • Conduct eligibility reviews and review ECHO benefits • Complete non-clinical overviews of assessments • Document and pend tasks to appropriate queues for completion or additional information requests • Answer inbound TRICARE Autism Care Demonstration calls using available resources • Educate beneficiaries and providers about the TRICARE ACD program • Monitor phone queues and web chats for provider and beneficiary inquiries • Report to a Supervisor of Care Management Support

🎯 Requirements

• Work a shift of 10:30 a.m. - 7 p.m. E.T. • 2 or more years of medical coding and/or behavioral health experience • 3 or more years of experience in customer service or referral management, handling high volume of work with a deadline • 3 years of experience in healthcare, medical, or health insurance field • U.S. citizenship required • Successfully receive approval for government security clearance via National Background Investigation Services (NBIS) • Must not currently live in Puerto Rico • Ability to work Monday through Friday, 10:30 a.m.–7 p.m. EST • Ability to work mandatory training hours of 8 a.m.–4:30 p.m. EST for the first 4–6 weeks • Home internet with at least 25 Mbps download and 10 Mbps upload speed • Dedicated workspace 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 • Personal wellness support • Smart healthcare decision support • Occasional travel to Humana offices for training or meetings