Utilization Management Coordinator

🔥 0 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $40k - $52.3k / year

⏰ Full Time

🟢 Junior

🚫👨‍🎓 No degree required

🦅 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 and document incoming inpatient and outpatient prior authorization requests according to Humana policies and procedures • Contact providers by phone or fax to request additional information or clarification • Conduct inbound and outbound calls • Work with internal and external customers and providers regarding prior authorization request status • Take provider calls regarding prior authorization status • Enter prior authorization requests into the TruCare database • Prepare documentation and assign tasks to appropriate staff for clinical review • Multitask throughout the day to meet the needs of multiple stakeholders

🎯 Requirements

• One (1) year of experience working in a health care setting or health plan setting • 1–2 years of experience working in Microsoft Office software applications, specifically Word, Excel, and PowerPoint • 1 year of customer service experience with either inbound and outbound phone calls • Work 8:30–5:00 pm CST, Monday through Friday, with limited availability for rotated holiday coverage • Preferred: 1 year of experience in prior authorization or utilization management • Preferred: 1 year of experience working in a health insurance environment • Preferred: Reside in the State of Wisconsin • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Work from a dedicated space lacking 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 • Remote home workstyle • Occasional use of Humana office space for collaboration and face-to-face needs • Internet service requirements/support for home work • Dedicated workspace to protect member PHI/HIPAA information