UM Administration Coordinator

Humana • Full-time • Remote (United States) • $40k - $52.30k / year • 3d ago

Become a part of our caring community

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.

As a UM Coordinator you will report to the Manager, UM Administration. You will be part of our fast-paced Clinical Call Center where you will engage with Providers on a daily basis, answering about 30-50 calls per day, and assist with determining the services they will be providing to a member requiring authorization or referral. The Provider may be calling in to get status of an authorization; or provide clinical information for a pended authorization.

As a UM coordinator you will be collecting clinical information and reviewing resources and data to determine positive outcomes for our consumers. This position requires the use of multiple systems, therefore the ability to maneuver multiple systems at one time is vital. In this role you will:

Take inbound calls to engage members and/or providers to verify clinical information
Handle customer inquiries both telephonically and by fax
Document all call information according to standard operating procedures and attach clinical information when necessary
Identify and escalate issues

Use your skills to make an impact

Required Qualifications

Experience with Utilization Review and/or Prior Authorization within a managed care call center
Experience with CGX, Genesys, DIG Toolbar, and SRO
UM Clinical intake process experience in Medicare, Medicaid, and DSNP
Demonstrated ability to articulate ideas effectively in both written and oral forms
Ability to multitask within several computer systems, including Word and Excel, while on the phone
Aptitude for quickly learning and navigating new technology systems and applications
Must be able to type while taking calls
Must have a private office to protect confidential information

Preferred Qualifications

Bachelor's Degree in Business, Finance or a related field
Proficient utilizing electronic medical record and 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

Workstyle: This is a remote position.
Core Workdays & Hours: Must be able to work any shift Monday – Friday; 7am – 7pm Central Standard Time (CST).

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$40,000 - $52,300 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 07-21-2026

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

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. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.