Talent.com
UM Administration Coordinator

UM Administration Coordinator

South Carolina StaffingColumbia, SC, US
13 hours ago
Job type
  • Full-time
Job description

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 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

    To ensure Home or Hybrid Home / Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home / Office associates must meet the following criteria :

  • 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

    The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $40,000 - $52,300 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.

    Application Deadline

    11-20-2025

    About Us

    Humana Inc. (NYSE : HUM) 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. 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. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. 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. See our https : / / www.humana.com / legal / accessibility-resources?source=Humana_Website.

    Create a job alert for this search

    Um Coordinator • Columbia, SC, US

    Related jobs
    • Promoted
    • New!
    Impound Coordinator - US Remote

    Impound Coordinator - US Remote

    Motorola SolutionsColumbia, SC, US
    Remote
    Full-time
    At Motorola Solutions, we believe that everything starts with our people.We're a global close-knit community, united by the relentless pursuit to help keep people safer everywhere.Our critical comm...Show moreLast updated: 14 hours ago
    • Promoted
    Home Health Physical Therapist

    Home Health Physical Therapist

    Interim HealthCare IncElloree, SC, US
    Full-time +1
    Interim HealthCare Inc is seeking a Home Health Physical Therapist for a job in Elloree, South Carolina.Job Description & Requirements. Discover a new lane in therapy where treatments are person...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Physical Therapist Home Health ($10k Sign-on Bonus!)

    Physical Therapist Home Health ($10k Sign-on Bonus!)

    Interim HealthCareNorth, SC, US
    Full-time +1
    Discover a new lane in therapy where treatments are personal and outcomes are optimal.As a Home Health Physical Therapist, you’ll help patients regain their strength, manage their pain and re...Show moreLast updated: 12 hours ago
    • Promoted
    Licensed Clinical Therapist (LISW-CP / LPC / LMFT)

    Licensed Clinical Therapist (LISW-CP / LPC / LMFT)

    LifeStance HealthJenkinsville, SC, US
    Full-time
    At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better. Our mission is to help people lead healthier, more fulfilling lives...Show moreLast updated: 16 days ago
    • Promoted
    Surrogates Start at $55K–$75K+ | $1,200 Bonus + $11K Pre-Pregnancy Payout

    Surrogates Start at $55K–$75K+ | $1,200 Bonus + $11K Pre-Pregnancy Payout

    Physician's SurrogacyWinnsboro, SC, US
    Full-time +2
    Earn up to $75,000 as a stay-at-home mom or as a second job.Sign up today and earn $1,200 bonus.What qualities make you a great Surrogate?. Experienced no complications during your own pregnancy.Hea...Show moreLast updated: 9 days ago
    • Promoted
    Travel Nurse RN - ED - Emergency Department

    Travel Nurse RN - ED - Emergency Department

    Malone Healthcare - NursingWinnsboro, SC, US
    Full-time
    Malone Healthcare - Nursing is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Winnsboro, South Carolina. Job Description & Requirements.F3E5; Position Summary\n\...Show moreLast updated: 30+ days ago
    • Promoted
    Managed Care Coordinator UM II

    Managed Care Coordinator UM II

    Spectraforce TechnologiesColumbia, SC, United States
    Full-time
    Role Name : Managed Care Coordinator UM II.Work Environment : (Remote after 4-6 weeks of Onsite training).Contract length : 3 months assignment with possible conversion. Reviews and evaluates medical o...Show moreLast updated: 30+ days ago
    • Promoted
    Administrative Coordinator

    Administrative Coordinator

    InsideHigherEdColumbia, South Carolina, United States
    Full-time
    Salary commensurate with qualifications.From the Upstate to the Lowcountry, the University of South Carolina system is transforming the lives of South Carolinians through the impact of our eight in...Show moreLast updated: 30+ days ago
    • Promoted
    • New!
    Administrative Coordinator I

    Administrative Coordinator I

    State of South CarolinaCayce, SC, United States
    Full-time
    Department of Behavioral Health and Developmental Disabilities.Greater Bryan Psychiatric Hospital.Agency Specific Application Procedures : : . Please complete the state application to include all curre...Show moreLast updated: 11 hours ago
    • Promoted
    Travel Emergency Department Registered Nurse

    Travel Emergency Department Registered Nurse

    Ethos Medical StaffingWinnsboro, SC, US
    Full-time
    Ethos Medical Staffing is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Winnsboro, South Carolina. Job Description & Requirements.Ethos Medical Staffing Job ID ...Show moreLast updated: 30+ days ago
    • Promoted
    Surrogates Start at $55K-$75K+ $1,200 Bonus + $11K Pre-Pregnancy Payout

    Surrogates Start at $55K-$75K+ $1,200 Bonus + $11K Pre-Pregnancy Payout

    Physician's SurrogacyBlythewood, SC, US
    Full-time +2
    Earn up to $75,000 as a stay-at-home mom or as a second job.Sign up today and earn $1,200 bonus.What qualities make you a great Surrogate?. Experienced no complications during your own pregnancy.Hea...Show moreLast updated: 9 days ago
    • Promoted
    • New!
    Flexible schedule - Earn at least $755 by driving 69 trips with Uber

    Flexible schedule - Earn at least $755 by driving 69 trips with Uber

    UberSalley, GA, US
    Full-time +1
    Earn at least $755 driving with Uber when you complete your first 69 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 4 hours ago
    • Promoted
    • New!
    UM Coordinator 2 - Weekend Work

    UM Coordinator 2 - Weekend Work

    South Carolina StaffingColumbia, SC, US
    Full-time
    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...Show moreLast updated: 2 hours ago
    • Promoted
    Surrogates Start at $55K$75K+ with $1,200 Bonus + $11K Pre-Pregnancy Payout

    Surrogates Start at $55K$75K+ with $1,200 Bonus + $11K Pre-Pregnancy Payout

    Physician's SurrogacyBlythewood, SC, US
    Full-time +2
    Earn up to $75,000 as a stay-at-home mom or as a second job.Sign up today and earn $1,200 bonus.What qualities make you a great Surrogate?. Experienced no complications during your own pregnancy.Hea...Show moreLast updated: 9 days ago
    • Promoted
    • New!
    Choose your schedule - Earn At Least $755 For Your First 69 Trips, Guaranteed.

    Choose your schedule - Earn At Least $755 For Your First 69 Trips, Guaranteed.

    UberWagener, GA, US
    Full-time +1
    Earn at least $755 driving with Uber when you complete your first 69 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 4 hours ago
    • Promoted
    Outpatient Registered Nurse - RN

    Outpatient Registered Nurse - RN

    Fresenius Medical CareWinnsboro, South Carolina, US
    Full-time
    The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and co...Show moreLast updated: 3 days ago
    • Promoted
    Surrogates Start at $55K–$75K+ — Includes $1,200 Bonus + $11K Pre-Pregnancy Payout

    Surrogates Start at $55K–$75K+ — Includes $1,200 Bonus + $11K Pre-Pregnancy Payout

    Physician's SurrogacyBlythewood, SC, US
    Full-time +2
    Earn up to $75,000 as a stay-at-home mom or as a second job.Sign up today and earn $1,200 bonus.What qualities make you a great Surrogate?. Experienced no complications during your own pregnancy.Hea...Show moreLast updated: 9 days ago
    • Promoted
    • New!
    Flexible schedule - Earn at least $1535 by driving 127 trips with Uber

    Flexible schedule - Earn at least $1535 by driving 127 trips with Uber

    UberLittle Mountain, SC, US
    Full-time +1
    Earn at least $1535 driving with Uber when you complete your first 127 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, pa...Show moreLast updated: 4 hours ago