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Humana UM Administration Coordinator 2 - Work at Home, Mountain and Pacific Time Only in Phoenix, Arizona

Description

The UM Specialist contributes to administration of utilization management. The UM Specialist performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Responsibilities

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 are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.

Key Responsibilities:

  • Attaching faxes for chart reviews for the nursing team

  • Answering departmental phones as assigned

  • Make outbound calls to engage members and/or providers to verify clinical information/discharge date and admission status

  • Document calls and attach clinical information received

  • Request clinical information from providers/facilities

  • Create and send out written correspondence

  • Ability to multitask and prioritize

  • Collaborate with multiple roles/departments/providers/team members

Required Qualifications

  • 1 or more years of administrative, call center or customer service experience

  • Excellent verbal and written communication skills

  • Exceptional phone etiquette

  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

  • Comprehensive knowledge of Microsoft Word, Outlook and Excel with the ability to type and enter data accurately, as well as the ability to quickly learn new systems

  • Ability to provide a designated workspace; free from distractions with the ability to secure any protected information

  • Must have the ability to provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required

  • Associates working in the state of Arizona must comply with the Tobacco Free Hiring Policy (see details below under Additional Information) and upon offer will be subjected to nicotine testing as part of a 10 panel drug test

Preferred Qualifications

  • Clerical support background in a healthcare environment

  • Familiarity with medical terminology a plus

  • Prior member service or customer service telephone experience a plus

Additional Information

  • Hours for this role are: Monday-Friday with an occasional weekend 7am-6pm Mountain or Pacific Time (8 hour shift will fall between this this time)

  • The following policy applies ONLY to associates working in the state of Arizona: Humana is committed to providing a safe and healthy work environment and to promoting the health and well-being of its associates. Effective April 1, 2011, Humana has adopted a tobacco-free hiring policy that will promote a healthier workplace and will not hire users of tobacco and nicotine products. If you have any questions, please consult with your recruiter.

Scheduled Weekly Hours

40

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