About The Company Humana Inc. is a leading healthcare organization dedicated to improving the health and well-being of its members. As a prominent provider of insurance services and healthcare solutions through its subsidiaries, including CenterWell, Humana strives to deliver accessible, high-quality care tailored to the diverse needs of individuals and communities across the United States.
With a commitment to innovation and compassion, Humana seeks to make healthcare simpler, more affordable, and more personalized, fostering healthier lives and stronger communities. The company's mission emphasizes supporting whole-person well-being, integrating health and wellness services to create meaningful impacts on people's lives.
About The Role The UM Administration Coordinator plays a vital role within Humana’s healthcare operations, primarily contributing to the administration of utilization management processes. This position involves performing a variety of administrative, operational, and customer support activities that are moderately complex, ensuring the efficient management of member care and services.
The coordinator provides non-clinical support to ensure adherence to policies and procedures that promote appropriate treatment, care, and service delivery for members. Working under minimal supervision, the role requires interpreting policies, prioritizing tasks, and making independent decisions within defined parameters. The coordinator works within standard practices but has some discretion over work prioritization and timing, contributing to the overall effectiveness of the utilization management team.
Qualifications
Minimum of 1 year of experience in an administrative or technical support role within a healthcare organization
Excellent verbal and written communication skills
Proficiency in MS Office Suite including Word, Excel, and Outlook in a Windows environment
Ability to quickly learn new systems and electronic documentation tools
Preferred: Experience with electronic medical records and documentation programs
Preferred: Knowledge of medical terminology and ICD-10 coding
Bachelor’s Degree in Business, Finance, or related field
Prior experience in member or customer service via telephone is desirable
Experience with Utilization Review and/or Prior Authorization processes within managed care organizations is a plus
Responsibilities
Assist in the administration of utilization management activities to ensure compliance with organizational policies
Support the review and processing of prior authorization requests and utilization reviews
Maintain accurate and timely documentation within electronic medical records systems
Communicate effectively with members, providers, and internal teams to facilitate care coordination
Perform computations and data entry tasks related to utilization management metrics
Interpret policies and procedures to support appropriate member care decisions
Prioritize and manage multiple tasks efficiently within established deadlines
Assist in generating reports and analyzing data related to utilization management activities
Support training and onboarding activities as needed, including participation in meetings and training sessions
Ensure compliance with HIPAA and other privacy regulations to protect member information
Benefits
Competitive annual salary ranging from $40,000 to $52,300, commensurate with experience and location
Comprehensive health benefits, including medical, dental, and vision coverage
401(k) retirement savings plan with company contributions
Paid time off, including holidays, personal days, and paid parental/caregiver leave
Short-term and long-term disability insurance
Life insurance and wellness programs
Opportunities for professional development and career growth
Remote work flexibility with required home office setup
Equal Opportunity
Humana is an Equal Opportunity Employer. We are committed to creating an inclusive environment where all employees and applicants are treated with respect and fairness. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status.
Humana actively promotes affirmative action and ensures employment decisions are based solely on valid job requirements. We support diversity and inclusion at all levels of our organization, fostering a workplace where everyone can thrive and contribute to our mission of making healthcare better for all.