UM Administrative Coordinator - Humana
Boston, MA
About the Job
Become a part of our caring community and help us put health first
The UM Administration Coordinator 2 provides clerical support for the department. We are the beginning, middle and end of processes for utilization management. This role partners with leadership, Medical Directors, Nurses and with other team members.
Achieve your best at Humana. Join Us! 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.
The Home Solutions UM Team is hiring for a UM Administration Coordinator 2 that will provide non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members utilizing Home Health and Skilled Nursing Facility services. This team sits in the Home Solutions organization and contributes to the Value-Based segment partnering with CenterWell and Onehome.
+ Manages NLP's for chart reviews for the nursing team
+ Builds and pends authorizations for review
+ Responsible for inbound and outbound calls to engage providers and members to verify clinical information/discharge date and admission status throughout the day
+ Documents calls and attaches clinical information received
+ Requests clinical information from providers/facilities
+ Creates and sends out written correspondence
+ Creates and distributes determination letters
+ Collaborates with multiple roles/departments/providers/team members
REMINDER: ATTACH A COPY OF YOUR RESUME
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
+ Medical Benefits
+ Dental Benefits
+ Vision Benefits
+ Health Savings Accounts
+ Flex Spending Accounts
+ Life Insurance
+ 401(k)
+ PTO including 8 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
+ And more
Use your skills to make an impact
Required Qualifications
+ 1 or more years administrative or technical support experience
+ Excellent verbal and written communication skills
+ Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
+ Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
+ Proficient utilizing electronic medical record and documentation programs
+ Proficient and/or experience with medical terminology and/or ICD-10 codes
+ Bachelor's Degree in Business, Finance or a related field
+ Prior member service or customer service telephone experience desired
+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
Additional Information
Scheduled Weekly Hours
40
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.
$37,200 - $51,200 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.
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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
The UM Administration Coordinator 2 provides clerical support for the department. We are the beginning, middle and end of processes for utilization management. This role partners with leadership, Medical Directors, Nurses and with other team members.
Achieve your best at Humana. Join Us! 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.
The Home Solutions UM Team is hiring for a UM Administration Coordinator 2 that will provide non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members utilizing Home Health and Skilled Nursing Facility services. This team sits in the Home Solutions organization and contributes to the Value-Based segment partnering with CenterWell and Onehome.
+ Manages NLP's for chart reviews for the nursing team
+ Builds and pends authorizations for review
+ Responsible for inbound and outbound calls to engage providers and members to verify clinical information/discharge date and admission status throughout the day
+ Documents calls and attaches clinical information received
+ Requests clinical information from providers/facilities
+ Creates and sends out written correspondence
+ Creates and distributes determination letters
+ Collaborates with multiple roles/departments/providers/team members
REMINDER: ATTACH A COPY OF YOUR RESUME
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
+ Medical Benefits
+ Dental Benefits
+ Vision Benefits
+ Health Savings Accounts
+ Flex Spending Accounts
+ Life Insurance
+ 401(k)
+ PTO including 8 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
+ And more
Use your skills to make an impact
Required Qualifications
+ 1 or more years administrative or technical support experience
+ Excellent verbal and written communication skills
+ Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
+ Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
+ Proficient utilizing electronic medical record and documentation programs
+ Proficient and/or experience with medical terminology and/or ICD-10 codes
+ Bachelor's Degree in Business, Finance or a related field
+ Prior member service or customer service telephone experience desired
+ Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
Additional Information
Scheduled Weekly Hours
40
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.
$37,200 - $51,200 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.
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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Source : Humana