Utilization Management Coordinator

Job not on LinkedIn

🔥 0 minutes ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $40k - $52.3k / year

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

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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 Physical Health utilization management • Provide non-clinical support for Utilization Management Nurses and Physical Health Medical Directors • Process requests for authorization of health services • Interpret area and department policies and methods for completing assignments • Identify work expectations and quality standards within defined parameters • Prioritize and schedule work with some independent discretion • Support appropriate treatment, care, and services for members • Protect member PHI/HIPAA information while working from a dedicated space • Travel occasionally to Humana offices for training or meetings when required

🎯 Requirements

• 1 or more years of administrative or technical support experience • Working knowledge of MS Office, including Word, Excel, and Outlook • Ability to work in a Windows-based environment • Ability to quickly learn new systems • Passion for contributing to continuous improvement of consumer experiences • Proficiency using electronic medical record and documentation programs preferred • Proficiency and/or experience with medical terminology and/or ICD-10 codes preferred • Bachelor's Degree in Business, Finance, or a related field preferred • Prior member service or customer service telephone experience desired • Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization • Minimum download speed of 25 Mbps and upload speed of 10 Mbps for home internet • Dedicated work space without ongoing interruptions to protect member PHI/HIPAA information

🏖️ 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 • Competitive benefits supporting whole-person well-being • Personal wellness support • Home-based work arrangement