Humana Looking For Utilization Management Coordinator at Cincinnati, OH Full Time

The Physical Health, PH ,UM Administration Coordinator 2 contributes to administration of PH utilization management. The UM Administration Coordinator 2 provides non-clinical support for UM Nurses and PH Medical Directors to ensure the best and most appropriate treatment, care or services for members.

Responsibilities

The UM Administration Coordinator 2 processes requests for authorization of health services, requiring interpretation of area/department policy and methods for completing assignments. The UM Coordinator 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 health care administrative or technical support experience

Excellent verbal and written communication skills

Intermediate 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

Workstyle: Remote work at home

Location: Must reside in Ohio

Hours: Must be able to work a 40 hour work week, Monday through Friday 8:00 AM to 5:00 PM Eastern Time, over-time may be requested to meet business needs.

Work at Home Requirements:
Must have a separate room with a locked door that can be used as a home office to ensure absolute and continuous privacy during while you work

Must have accessibility to hardwired high speed internet with minimum speeds of 25Mx10M for a home office (Wireless and Satellite are prohibited)

Preferred Qualifications

Bachelor’s or Associate’s Degree in Health care, Business, Finance or a related field

Experience working in Medicaid or Medicare

Experience working in a Utilization Management in a provider or payer environment.

Proficient utilizing electronic medical record and clinical documentation programs

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

Prior member service or customer service telephone experience desired

Additional Information

Additional Information

Interview Format

As part of our hiring process for this opportunity, we will be using an exciting screening and interviewing technology called Modern Hire to enhance our hiring and decision-making ability. We use this technology to gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

You will be able to respond to the recruiters preferred response method via text, video or voice technologies If you are selected for a screen, you may receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate. You should anticipate this screen to take about 15 to 30 minutes. Your recorded screen will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Covid Compliance Policy

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.

Scheduled Weekly Hours

40