Behavioral Health Utilization Management Administration Coordinator

Descrizione del lavoro:

Become a part of our caring community

The UM Administration Coordinator contributes to administration of utilization management. The UM Administration Coordinator 2 performs basic administrative, clerical, operational, customer support, and computational tasks working on semi-routine and patterned assignments.

The UM Administration Coordinator provides non-clinical support, following established policies and procedures ensuring best and most appropriate treatment, care, or services for members.
* Prepare and forward authorization request to clinical review
* Works within defined parameters to identify work expectations and quality standards, but has some autonomy over prioritization/timing.
* Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Key Responsibilities:
* Complete inbound and outbound provider calls to answer UM related questions and prepare authorization request for clinical review
* Document calls and attach clinical information to the member's medical record
* Create and send out written correspondence
* Ability to multitask and prioritize
* Collaborate with multiple roles/departments/providers/team members

Use your skills to make an impact

Required Qualifications
* Minimum 1 year administrative experience in healthcare field.
* 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 and ability to troubleshoot and resolve basic technical difficulties in a remote environment.
Preferred Qualifications
* Proficient utilizing electronic medical record and documentation programs
* Prior member service or customer service telephone experience desired
* Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization
* Clerical support background in a healthcare environment
* Familiarity with medical terminology and/or ICD-10 codes

Workstyle: Remote work at home
Preferred Location: Louisiana or Oklahoma
Training Schedule: Must be able to attend training schedule. Monday through Friday; 8:00 AM - 5:00 PM Central Time
Work Schedule:
* Monday through Friday 8:00 AM - 5:00 PM Central with rotating holidays and weekends

Travel: Minimal travel for office meetings 1-2 times annually as business needs require

Additional Information
Section 1121 of the Louisiana Code of Governmental Ethics states that current or former agency heads or elected officials, board or commission members or public employees of the Louisiana Health Department (LDH) who work directly with LDH's Medicaid Division cannot be considered for this opportunity. A separation of two (2) or more years from LDH is required for consideration.

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 RangeThe 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 BenefitsHumana, 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.

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.

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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