Utilization Management (UM) Coordinator

The Utilization Management (UM) Coordinator contributes to the administration of Utilization Management.

Job Responsibilities:

• Provide non-clinical support for policies and procedures to ensure best and most appropriate treatment, care, or services for enrollees.
• Assist providers with discharge planning for enrollees with inpatient stays or outpatient physical health.
• Work on special projects with the clinical team.
• Complete provider-facing responsibilities.

Required Qualifications:

• Reside in Oklahoma.
• 1 or more years of administrative or technical support experience.
• Working knowledge of MS Office, including Word, Excel, and Outlook in a Windows-based environment, and an ability to quickly learn new systems.

Preferred Qualifications:

• Proficient in using electronic medical records and documentation programs.
• Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization.
• Proficient in 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.

Additional Information:

• Occasional Saturday rotations may be required.
• Must have a dedicated workspace with minimal interruptions to protect member PHI/HIPAA information.
• Travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours: 40

Pay Range: $40,000 - $52,300 per year

Benefits: Humana offers competitive benefits that support whole-person well-being, including medical, dental, and vision benefits, 401(k) retirement savings plan, time off, short-term and long-term disability, life insurance, and more.