Interested in working from home? Interested in being and advocate and making a difference in the lives of others. Join our contact center and experience a supportive team environment as a pharmacy authorization specialist (also known as a UM Administration Coordinator 1.) The UM Administration Coordinator 1 contributes to the administration of utilization management and performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments.
The UM Administration Coordinator 1 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Decisions are limited to defined parameters around work expectations, quality standards, priorities and timing, and works under close supervision and/or within established policies/practices and guidelines with minimal opportunity for deviation.
Location: Remote position, with a preference for candidates within AZ, CO, ID, MT, NM, UT, & WY
Schedule: The hours of operations for this department are 8:00AM-11:00PM EST. Your 8 hour shift will fall within this timeframe based upon the business needs determined after training. There is a high probability for a mid or evening shift. Schedules can be M-F or include a Saturday or Sunday (not both). Candidates must be open to these schedule possibilities.
Position Type: Full time
Strong attention to detail
Strong typing and computer navigation skills
Ability to manage multiple or competing priorities, including use of multiple computer applications simultaneously
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
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 have internet service (not provided by Humana) and MUST have a minimal download speed of (25) and upload speed of (10) prior to start date that is DSL or Cable (Satellite service is NOT allowed.) Job offer is contingent on internet service
Associate or Bachelor degree
Previous contact center or related customer service experience
Fluency in Spanish strong preferred
Proficient utilizing electronic medical record and documentation programs
Proficient and/or experience with medical terminology and/or ICD-10 codes
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
Previous employment with work at home background
As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.
If you are selected for a first round interview, you will receive an email/text correspondence inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from [email protected] with instructions to add the information into the application at Humana’s secure website.
WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Scheduled Weekly Hours