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Utilization Management Administration Coordinator III - Correspondence

Utilization Management Administration Coordinator III - Correspondence

CenterwellPhiladelphia, PA, US
2 days ago
Job type
  • Full-time
Job description

Join Our Caring Team

The UM Administration Coordinator 3 contributes to administration of utilization management. The UM Administration Coordinator 3 performs advanced administrative / operational / customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.

The UM Administration Coordinator 3 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 methods, tactics and processes for completing administrative tasks / projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience / breadth and depth of knowledge of administrative processes and organizational knowledge.

Required Qualifications

  • 3 or more years Administrative or technical support experience
  • Excellent verbal and written communication skills
  • Advanced knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
  • Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); recommended speed is 10Mx1M
  • Proficient utilizing electronic medical record and documentation programs
  • Proficient and / or experience with medical terminology and / or ICD-10 codes
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

  • Bachelor's Degree in Business, Finance or a related field
  • Prior member service or customer service telephone experience desired
  • Experience with Utilization Review and / or Prior Authorization, preferably within a managed care organization
  • Additional Information

  • As part of our hiring process for this opportunity, we will be using a technology called Montage Voice which allows us to quickly connect and gain valuable information from you about your relevant experience.
  • If you are selected for a phone screen you will receive an email inviting you to participate in a Montage Voice interview. During this call you will be asked a set of questions pertaining to this particular role and you will provide recorded responses. The entire process takes about 15-20 minutes and can be done at your convenience. Your responses will be reviewed and you will be informed if you were selected for an in person or video interview, depending on your location.
  • 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 Range : $43,000 - $56,200 per year

    Description of Benefits : Humana, 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

    About Us

    About Conviva Senior Primary Care : Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being.About CenterWell, a Humana company : CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE : HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

    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.

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    Utilization Management Coordinator • Philadelphia, PA, US

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