# Utilization Management (UM) Coordinator

**Company**: Humana
**Location**: Remote Wisconsin
**Work arrangement**: remote
**Job type**: full-time
**Salary**: $40,000 - $52,300 per year
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-Wisconsin/Utilization-Management-Coordinator_R-436858?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/utilization-management-um-coordinator-c6acdab3-e6b/

## Description

Humana is seeking a Utilization Management (UM) Coordinator to join the Wisconsin Medicaid Market (iCare) team. As a UM Coordinator, you will provide non-clinical support for policies and procedures to ensure best and most appropriate treatment, care, or services for members.

Responsibilities:

- Process and document all incoming inpatient and outpatient prior authorization (PA) requests as outlined by Humana policies and procedures.

- Contact providers via phone or fax to request additional information or clarification as needed per established process.

- Conduct inbound and outbound calls.

- Work with customers/providers, both internally and externally, regarding the status of PA requests.

- Enter PA requests into the prior authorization database (TruCare), prepare documentation, and tasks to the appropriate staff member for clinical review.

- Multitask consistently throughout the day to meet the needs of multiple stakeholders.

Requirements:

- One (1) year of experience working in a healthcare setting or health plan setting.

- 1-2 years of experience working in Microsoft Office software applications, specifically Word, Excel, and PowerPoint.

- 1 year of customer service experience with either inbound and outbound phone calls.

- Work Monday through Friday, 8:30-5pm CST (limited availability needed for rotated holiday coverage).

Preferred Qualifications:

- 1 year of experience in prior authorization or utilization management.

- 1 year of experience working in a health insurance environment.

- Reside in the State of WI.

Benefits:

- 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.

Workstyle:

- Remote workstyle, with occasional travel to Humana's offices for training or meetings.

Scheduled Weekly Hours:

- 40

Pay Range:

- $40,000 - $52,300 per year

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## Skills

### Required
- Microsoft Office
- customer service
- prior authorization
- utilization management

### Nice to have
- health insurance

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Source: [Apply at humana.wd5.myworkdayjobs.com](https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-Wisconsin/Utilization-Management-Coordinator_R-436858?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)