Compliance UMAC 3 – Wed-Sun

🕒 July 30

🇺🇸 United States – Remote

💵 $44.9k - $60.2k / year

⏰ Full Time

🟢 Junior

🚔 Compliance

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 55%

What it means: the chance that no one is really hiring for this job.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

• Review utilization management activities and documentation for adherence to policies, procedures, and regulations • Collect and analyze data daily, weekly, monthly, or as needed to assess team and individual outcome and operational metrics • Understand department, segment, and organizational strategy and operating objectives and their linkages to related workstreams • Make decisions regarding work methods in ambiguous situations with minimal direction • Apply independent judgment, critical thinking, and interpretation of guidelines • Follow established guidelines, regulatory turnaround times, and procedures for processing QIO fast track appeals and expedited authorization requests • Work a four-day, ten-hour shift schedule Wednesday-Saturday or Thursday-Sunday • Attend occasional travel to Humana offices for training or meetings

🎯 Requirements

• 1 - 3 years of technical experience • Proficient in Microsoft Word & Excel • Strong attention to detail and accuracy • Passion for contributing to an organization focused on continuously improving consumer experiences • Excellent verbal and written communication skills • Clerical support background in a healthcare environment • Ability to work independently in an agile environment under general instructions and within a team • UM experience with auditing or compliance • UM experience with processing expedited requests or QIO appeals • Associates' or Bachelor's degree in Healthcare, Business, Finance, or related field • Familiarity with medical terminology and/or ICD-10 codes • Ability to provide high-speed DSL or cable modem for a home office; satellite and wireless internet are not allowed • Minimum internet speed of 25 Mbps download and 10 Mbps upload • Dedicated office 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 • Flexible schedule • Occasional overtime

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