Utilization Management Coordinator- Work at Home- Kentucky

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Job Information

Humana

Utilization Management Coordinator- Work at Home- Kentucky

in

Lexington

Kentucky

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

This is a Work at Home role, and you are required to live in the state of Kentucky

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

Work At Home Requirements: Must have a separate room with a locked door that can be used as a home office to ensure you and your members have absolute and continuous privacy while you work. Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required.

COVID Requirements

: For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

Provide proof of full vaccination, including booster or commit to testing protocols

*OR  *

Provide proof of applicable exemption including any required supporting documentation

​​ Medical, religious, state and (remote-only) work exemptions are available.

Preferred Qualifications

Proficient utilizing electronic medical record and documentation programs

Proficient and/or experience with medical terminology and/or ICD-10 codes

Prior experience serving Medicaid populations.

Prior member service or customer service telephone experience desired

Experience with Utilization Management and/or Prior Authorization, preferably within a managed care organization

Additional Requirements

Hours:

Monday -Friday 8am to 5pm. No overtime, weekend or holidays.

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com