Appeals Back End UM Admin Coordinator

About the role

The UM Administration Coordinator contributes to the administration of utilization management by performing basic administrative, clerical, operational, customer support, and computational tasks. This role provides administrative support for utilization management operations and processes, including reviewing and processing information, maintaining records, performing data entry, and supporting communications with internal and external stakeholders.

Working within established policies and procedures, the coordinator completes routine assignments, ensures accuracy and timeliness, and contributes to the efficient delivery of utilization management services. Work is performed under general supervision with guidance provided for non-routine situations.

Responsibilities

• Provide administrative support for utilization management (UM) programs and processes.
• Review, process, and maintain information and records accurately and in a timely manner.
• Coordinate communications with internal teams and external stakeholders.
• Support operational activities that help facilitate appropriate care and service delivery for members.
• Follow established policies, procedures, and work instructions to complete assigned tasks.
• Prioritize workload, maintain quality standards, and meet performance expectations.
• Collaborate effectively with team members to support departmental and business objectives.
• Perform work under general supervision, exercising judgment within established guidelines.

Requirements

• Experience providing administrative, operational, customer service, or technical support in a professional environment.
• Strong verbal and written communication skills with the ability to interact effectively with diverse audiences.
• Proficiency with Microsoft Office applications, including Word, Excel, and Outlook, and the ability to learn new systems and technologies.
• Ability to work independently in a remote environment and maintain a reliable internet connection that meets company requirements (minimum download speed of 25 Mbps and upload speed of 10 Mbps; wireless, wired cable, or DSL connection suggested).
• Strong organizational skills, attention to detail, and ability to manage multiple priorities in a fast-paced setting.
• Commitment to delivering exceptional service and contributing to a culture focused on improving customer and member experiences.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI/HIPAA information.

Preferred Qualifications

• Experience using electronic medical record (EMR), healthcare documentation, or case management systems.
• Familiarity with medical terminology, healthcare coding, or ICD-10 classifications.
• Associate's or bachelor's degree in Business, Healthcare Administration, Finance, or a related field.
• Prior customer service, member service, or call center experience.
• Experience supporting Utilization Management, Prior Authorization, Care Management, or related healthcare operations, preferably within a health plan or managed care environment.

Schedule

Scheduled weekly hours: 40 (full time).

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Pay

The pay range for this role is $39,000 - $49,400 per year. The range reflects a good faith estimate of starting base pay for full-time employment at the time of posting and may vary based on geographic location and individual qualifications.

Benefits

Humana offers competitive benefits designed to support whole-person well-being, including:

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off (including paid holidays, parental leave, and caregiver leave).
• Short-term and long-term disability.
• Life insurance.

Employees in California, Illinois, Montana, or South Dakota working from home will receive a bi-weekly payment for internet expenses. Telephone equipment will be provided to meet business requirements.