JobsEQ by Chmura Logo

Utilization Management Coordinator

Humana Inc.

Location: Owensboro, Kentucky
Type: Full-Time, Non-Remote
Posted on: March 14, 2023
This job is no longer available from the source.
Utilization Management Coordinator
Humana Inc. Owensboro, KY (Onsite) Full-Time
Apply on company site
Job Details
favorite_border
Description
The UM Administration Coordinator 2 contributes to administration of utilization management for Humana's KY Medicaid plan. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
Responsibilities
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.
Required Qualifications
* Minimum 1 year administrative or technical support 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
* Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Additional Requirements / Adherence
Workstyle: Remote Work at Home
Location: Must reside within 2 hours of driving distance of Louisville, KY
Schedule: Must be available to work a 40 hr. work week
* Monday - Friday 9:00 AM - 6:00 PM
Travel: Must be willing to travel a few times a year to the Local Market Office
Work at Home Guidance
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
* At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
* Satellite, cellular and microwave connection can be used only if approved by leadership
* Associates 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 associates 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
Covid Policy
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
Preferred Qualifications
* Associate or Bachelor's Degree in Business, Finance or health services
* Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
* Proficient utilizing electronic medical record and documentation programs
* Proficient and/or experience with medical terminology and/or ICD-10 codes
* Prior member service or customer service telephone experience desired
* Prior experience serving Medicaid populations.
Additional Information
Interview Process
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
#L1-Remote
Scheduled Weekly Hours
40
Recommended Skills
• Administration
• Business Requirements
• Clinical Works
• Communication
• Curiosity
• Customer Service
Apply to this job.
Think you're the perfect candidate?
Apply on company site
Help us improve CareerBuilder by providing feedback about this job: Report this job
Job ID: 2462233175
CareerBuilder TIP
For your privacy and protection , when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more.
By applying to a job using CareerBuilder you are agreeing to comply with and be subject to the CareerBuilder Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.