UM Administration Coordinator

Become A Part Of Our Caring Community And Help Us Put Health First

The UM Administration Coordinator 2 contributes to administration of 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.

Key Responsibilities:

Responsible for intercepting inbound calls and assisting facilities/providers in scheduling and coordinating Peer to Peer discussions

Managing Humana Medical Directors' calendars

Monitoring and decisioning authorizations

Responding to provider inquiries regarding existing authorizations, and providing timely updates as needed via fax or phone calls, ensuring compliance with organizational policies and applicable federal regulations

Maintaining high-quality standard and meeting monthly quality requirements

Ability in maneuvering multiple systems simultaneously

Core Competencies:

Communicate ideas and updates clearly to team members, actively listen to feedback and concerns, and facilitate open, honest dialogue.

Collaborate and contribute effectively to team projects and goals, supporting colleagues and resolving issues that impact the team.

Share knowledge, work effectively with cross-functional teams, and coordinate tasks and responsibilities among team members.

Use your skills to make an impact

Required Qualifications:

1 or more years' experience working in an administrative support capacity in a healthcare setting

Excellent verbal and written communication skills

Demonstrated attention to detail

Ability to navigate process flows and follow procedure documents

Working knowledge of MS Office including Word, Excel, Teams, and Outlook in a Windows based environment and an ability to quickly learn new systems

Must effectively manage personal responsibilities to ensure a professional work environment conducive to achieving performance goals

Preferred Qualifications:

Proficient utilizing electronic medical record and documentation programs

Prior experience with CGX and Genesys

Prior experience with post-acute authorizations

Prior experience in a metric driven environment

Prior experience in the healthcare industry

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

Prior member service or customer service telephone experience desired

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

Work-At-Home Requirements:

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

Additional Information:

Work hours are Monday-Friday 7am-7pm EST (Your 8-hour shift will fall within this timeframe)

Overtime available based upon business needs

Weekend and/or holiday coverage possible for this role

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: $40,000-$52,300 per year

Description of Benefits: Humana, Inc. offers competitive benefits that support whole-person well-being. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off, short-term and long-term disability, life insurance, and many other opportunities.

Application Deadline: 11-20-2025

About Us: Humana Inc. 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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services.