UM Administration Coordinator

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. Decisions typically focus on interpretation of area/department policy and methods for completing assignments. You will work within defined parameters to identify work expectations and quality standards, but have some latitude over prioritization/timing, and works under minimal direction. You will follow standard policies and practices that allow for some opportunity for interpretation/deviation and independent discretion. Provide Long- Term Services and Supports (LTSS) UM support by managing shared mailboxes and entering data into work queues and/or clinical documentation systems. Mail letters/educational material, prepare documents for LTSS UM (Utilization Management) reviewers and Medical Directors, and perform other administrative responsibilities as assigned. Ensure the timely and correct submission of state-required deliverables. Work with care coordinators and other internal and external stakeholders who guide members and their families toward and facilitate interaction with resources appropriate for care and well-being. Perform varied activities of clerical activities including perform computations, reporting data, tracking data, pulling reports and monitoring/managing email. Typically work on semi-routine assignments that are subject to change. May make, receive, and soft transfer calls to and from members, member's families and providers. Ensure timely communication and follow up occurs with care management. Use your skills to make an impact   Required Qualifications Must reside in Michigan. One (1) or more years of administrative experience in a healthcare environment. Strong verbal and written communication skills to support stakeholder communication and coordination. Working knowledge of Microsoft Word, Excel, and Outlook in a Windows-based environment and the ability to learn new software and systems.

Experience with LTSS programs. Experience with LTSS Utilization Review and/or Prior Authorization, preferably within a managed care organization. Proficient using electronic medical record and documentation programs. Proficient or experienced with medical terminology and/or ICD-10 codes. Prior member service or customer service telephone experience.

Workstyle: This position is remote. Work Schedule: Monday through Friday; 8:00 a.m. to 4:30 p.m. Eastern Time (ET), with flexibility to work additional hours as needed to support business priorities and operational demands. Training: The training period for this position is approximately 4 to 6 weeks and may require attendance outside of standard working schedule. We require full participation throughout onboarding and training to ensure successful completion of the program. While time off is generally not permitted during this period, we consider limited accommodations for essential needs on a case-by-case basis. 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 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for