UM Administration Coordinator 2

Become a part of our caring community and help us put health first

The UM Administration Coordinator 2 contributes to administration of LTSS utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

• Provides CM support by managing shared mailboxes and entering data into work queues, mailing letters/educational material, researching unable to contact members and will complete other administrative functions, as assigned.
• Ensure the timely and correct submission of Commonwealth-required deliverables, research alternative contact information for hard-to-reach members, contact members to engage them in our care management programs, and support inbound call escalations.
• Provide non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state.
• Interact with Service Coordinators and Field Care Managers who guide members and their families toward and facilitate interaction with resources appropriate for care and well-being.
• Perform varied activities clerical activities including reporting data, tracking data, pulling reports and monitoring/managing email.
• Performs computations.
• Typically works on semi-routine assignments that are subject to change.
• May make, receive, and soft transfer calls to and from members, providers, family, etc... Ensure timely communication and follow up occurs with care management.
  
  

Required Qualifications

Use your skills to make an impact

• Health care and/or health administrative experience
• Excellent verbal and written communication skills
• Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
  
  

Preferred Qualifications

• Proficient utilizing electronic medical record and documentation programs
• Proficient and/or experience with medical terminology and/or ICD-10 codes
• Bachelor's Degree in Business, Finance or a Health related field
• Prior member service or customer service telephone experience desired
• Experience with LTSS Utilization Review and/or Prior Authorization, preferably within a managed care organization
  
  

Workstyle: Remote work at Home

Location: Must reside in Virginia or within 40 miles of Virginia border; Occasional travel to office for staff meetings, training, etc.; This role will be regionally based in one of the Commonwealth’s six regions: Tidewater, Central, Northern/Winchester, Western/Charlottesville, Roanoke/Alleghany, Southwest.

Schedule: Must work a minimum of 8 hours between 8:00AM to 5:00 PM Eastern Time

Travel: Less than 25% onsite meeting based on market or business needs

Additional Information

Work at Home Guidance To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria. A minimum download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is required. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

SSN Alert: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana’s secure website.

Interview Format: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$40,000 - $52,300 per year

Description Of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.