Talent.com
UM Administration Coordinator

UM Administration Coordinator

Ohio StaffingColumbus, OH, US
Hace 1 día
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

Become A Part Of Our Caring Community And Help Us Put Health First

The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative / operational / customer support assignments. Performs computations. Typically works on semi-routine assignments. 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 :

  • Responsible for intercepting inbound calls and assisting facilities / providers in scheduling and coordinating Peer to Peer discussions
  • Managing Humana Medical Directors' calendars
  • Monitoring and decisioning authorizations
  • Responding to provider inquiries regarding existing authorizations, and providing timely updates as needed via fax or phone calls, ensuring compliance with organizational policies and applicable federal regulations
  • Maintaining high-quality standard and meeting monthly quality requirements
  • Ability in maneuvering multiple systems simultaneously

Core Competencies :

  • Communicate ideas and updates clearly to team members, actively listen to feedback and concerns, and facilitate open, honest dialogue.
  • Collaborate and contribute effectively to team projects and goals, supporting colleagues and resolving issues that impact the team.
  • Share knowledge, work effectively with cross-functional teams, and coordinate tasks and responsibilities among team members.
  • Use your skills to make an impact

    Required Qualifications :

  • 1 or more years' experience working in an administrative support capacity in a healthcare setting
  • Excellent verbal and written communication skills
  • Demonstrated attention to detail
  • Ability to navigate process flows and follow procedure documents
  • Working knowledge of MS Office including Word, Excel, Teams, and Outlook in a Windows based environment and an ability to quickly learn new systems
  • Must effectively manage personal responsibilities to ensure a professional work environment conducive to achieving performance goals
  • Preferred Qualifications :

  • Proficient utilizing electronic medical record and documentation programs
  • Prior experience with CGX and Genesys
  • Prior experience with post-acute authorizations
  • Prior experience in a metric driven environment
  • Prior experience in the healthcare industry
  • Proficient and / or experience with medical terminology and / or ICD-10 codes
  • Prior member service or customer service telephone experience desired
  • Experience with Utilization Review and / or Prior Authorization, preferably within a managed care organization
  • Work-At-Home Requirements :

  • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
  • Satellite, cellular and microwave connection can be used only if approved by leadership
  • Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense
  • Humana will provide Home or Hybrid Home / Office associates with telephone equipment appropriate to meet the business requirements for their position / job
  • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
  • Additional Information :

  • Work hours are Monday-Friday 7am-7pm EST (Your 8-hour shift will fall within this timeframe)
  • Overtime available based upon business needs
  • Weekend and / or holiday coverage possible for this role
  • 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 : $40,000-$52,300 per year

    Description of Benefits : Humana, Inc. offers competitive benefits that support whole-person well-being. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off, short-term and long-term disability, life insurance, and many other opportunities.

    Application Deadline : 11-20-2025

    About Us : Humana Inc. is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

    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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services.

    Crear una alerta de empleo para esta búsqueda

    Um Coordinator • Columbus, OH, US

    Ofertas relacionadas
    • Oferta promocionada
    CT Technologist - Full Time (will train registered RT)

    CT Technologist - Full Time (will train registered RT)

    OhioHealthCircleville, OH, US
    A tiempo completo
    We are more than a health system.We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to...Mostrar másÚltima actualización: hace 3 días
    • Oferta promocionada
    Travel CT Technologist

    Travel CT Technologist

    Nightingale Nurses - AlliedWashington Court House, OH, US
    A tiempo completo
    Nightingale Nurses - Allied is seeking a travel CT Technologist for a travel job in Washington Court House, Ohio.Job Description & Requirements.Mostrar másÚltima actualización: hace 4 días
    • Oferta promocionada
    Travel Nurse RN - ED - Emergency Department

    Travel Nurse RN - ED - Emergency Department

    GLC On-The-GoWashington Court House, OH, US
    A tiempo completo
    GLC On-The-Go is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Washington Court House, Ohio. Job Description & Requirements.Pay package is based on 8 hour shift...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Center Clinical Director, Associate

    Center Clinical Director, Associate

    ChenMedFulton, OH, US
    A tiempo completo
    We’re changing lives every day.For both our patients and our team members.Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire o...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Ohio Wesleyan University 2026 Faculty Cohort

    Ohio Wesleyan University 2026 Faculty Cohort

    InsideHigherEdDelaware, Ohio, United States
    A tiempo completo
    Ohio Wesleyan seeks to further strengthen its commitment to flexibility, interdisciplinarity, and inclusivity by filling six tenure-track positions for the 2026-2027 academic year.The OWU 2026 facu...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Travel Certified Occupational Therapy Assistant - LTC / SNF

    Travel Certified Occupational Therapy Assistant - LTC / SNF

    Core Medical GroupWashington Court House, OH, US
    Indefinido +1
    Core Medical Group is seeking a travel Skilled Nursing Facility (SNF) Certified Occupational Therapy Assistant for a travel job in Washington Courthouse, Ohio. Job Description & Requirements.Cer...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Travel Surgical Technologist

    Travel Surgical Technologist

    Talent4HealthLancaster, OH, US
    A tiempo completo
    Talent4Health is seeking a travel Surgical Technologist for a travel job in Lancaster, Ohio.Job Description & Requirements. Minimum Years of Experience : 3.A leader and innovator, offering compre...Mostrar másÚltima actualización: hace 2 días
    • Oferta promocionada
    Travel PCU / ICU Step-Down Registered Nurse

    Travel PCU / ICU Step-Down Registered Nurse

    Rang HealthcareWashington Court House, OH, US
    Indefinido
    Rang Healthcare is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Washington Court House, Ohio. Job Description & Requirements.FA7A; Staff Nurse – PCU Un...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Travel CT & X-ray Technologist

    Travel CT & X-ray Technologist

    FlexCare AlliedWashington Court House, OH, US
    A tiempo completo
    FlexCare Allied is seeking a travel CT Technologist for a travel job in Washington Ct House, Ohio.Job Description & Requirements. FlexCare Allied Job ID #JOB-01663339.Pay package is based on 8 h...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Licensed Crisis Therapist : Mobile Response and Stabilization Services

    Licensed Crisis Therapist : Mobile Response and Stabilization Services

    Applewood CentersLondon, OH, US
    A tiempo completo
    The MRSS Licensed Crisis Therapist will provide mobile response and stabilization services to youth (age 2-20) and families who have called the crisis hotline with a family identified crisis.The MR...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Licensed Crisis Clinical Supervisor : Mobile Response and Stabilization Services (MRSS)

    Licensed Crisis Clinical Supervisor : Mobile Response and Stabilization Services (MRSS)

    Applewood CentersLondon, OH, US
    A tiempo completo
    Under the supervision of the Mobile Response Stabilization Program Manager, the Licensed Shift Supervisor will take and assign crisis calls from the 24 / 7 hotline to have clinicians respond face to ...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Full Time CT Technologist (will train registered RT)

    Full Time CT Technologist (will train registered RT)

    OhioHealthCircleville, OH, US
    A tiempo completo
    We are more than a health system.We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to...Mostrar másÚltima actualización: hace 3 días
    • Oferta promocionada
    Memory Care Coordinator (LPN)

    Memory Care Coordinator (LPN)

    Danbury WestervilleNew Albany, OH
    A tiempo completo
    Quick Apply
    You don’t just clock in at a job.You walk in the door to a work family who wants to make the day count.We truly believe our employees and residents are a family that comes together to enjoy t...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Travel CT Technologist

    Travel CT Technologist

    AMN Healthcare AlliedMarysville, OH, US
    A tiempo completo
    AMN Healthcare Allied is seeking a travel CT Technologist for a travel job in MARYSVILLE, Ohio.Job Description & Requirements. Job Description & Requirements.Computed Tomography Technologist...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Travel Nurse RN - PCU - Progressive Care Unit

    Travel Nurse RN - PCU - Progressive Care Unit

    ProKatchersWashington Court House, OH, US
    A tiempo completo
    ProKatchers is seeking a travel nurse RN PCU - Progressive Care Unit for a travel nursing job in Washington Court House, Ohio. Job Description & Requirements.In this position responsibilities wi...Mostrar másÚltima actualización: hace más de 30 días
    • Oferta promocionada
    Travel CT Technologist

    Travel CT Technologist

    Ethos Medical StaffingWashington Court House, OH, US
    A tiempo completo
    Ethos Medical Staffing is seeking a travel CT Technologist for a travel job in Washington Court House, Ohio.Job Description & Requirements. Ethos Medical Staffing Job ID #34627794.Pay package is...Mostrar másÚltima actualización: hace 23 días
    • Oferta promocionada
    UM Coordinator 2 - Weekend Work

    UM Coordinator 2 - Weekend Work

    Columbus StaffingColumbus, OH, US
    A tiempo completo
    UM Administration Coordinator 2.Become a part of our caring community and help us put health first.The UM Administration Coordinator 2 contributes to administration of utilization management.The UM...Mostrar másÚltima actualización: hace 1 día
    • Oferta promocionada
    Travel Skilled Nursing Facility (SNF) Speech Language Pathologist

    Travel Skilled Nursing Facility (SNF) Speech Language Pathologist

    American TravelerLondon, OH, US
    A tiempo completo
    American Traveler is seeking a travel Skilled Nursing Facility (SNF) Speech Language Pathologist for a travel job in London, Ohio. Job Description & Requirements.American Traveler seeks a Speech...Mostrar másÚltima actualización: hace más de 30 días