UM Administration Coordinator

Become a part of our caring community

The UM Administration Coordinator 1 contributes to administration of utilization management. The UM Administration Coordinator 1 performs basic administrative/clerical/operational/customer support/computational tasks. Typically works on routine and patterned assignments.
The UM Administration Coordinator provides non-clinical administrative support for utilization management activities that help ensure members receive appropriate care and services. This role follows established processes, policies, and quality standards while supporting efficient and accurate operational workflows.
Key Responsibilities

- Support utilization management policies, procedures, and operations.

- Assist with activities that promote appropriate member care and services.

- Complete administrative tasks following established guidelines and procedures.

- Maintain accurate records and documentation.

- Meet quality, productivity, and timeliness expectations.

- Prioritize and complete assigned work within designated timeframes.

- Adhere to departmental policies, compliance requirements, and performance standards.

- Escalate issues that fall outside established guidelines.

- Collaborate with internal teams to support operational goals.

- Perform work under close supervision and within defined processes.

Use your skills to make an impact

Required Qualifications :

- Administrative or technical support experience

- Excellent verbal and written communication skills

- 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

Preferred Qualifications

- Previous contact center or related customer service experience with telephone experience desired

- Healthcare experience

- High School diploma

- 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

Additional Information:

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
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.

- Satellite, cellular and microwave connection can be used only if approved by leadership.

- Employees 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.

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Humana will provide Home or Hybrid Home/Office employees 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.

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 sufficie