Location: Montpelier,VT, USA
Become a part of our caring community and help us put health firstThe UM Administration Coordinator 2 provides clerical support for the department. We are the beginning, middle and end of processes for utilization management. This role partners with leadership, Medical Directors, Nurses and with other team members.Achieve your best at Humana. Join Us! 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.The Home Solutions UM Team is hiring for a UM Administration Coordinator 2 that will provide non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members utilizing Home Health and Skilled Nursing Facility services. This team sits in the Home Solutions organization and contributes to the Value-Based segment partnering with CenterWell and Onehome.Manages NLP's for chart reviews for the nursing teamBuilds and pends authorizations for reviewResponsible for inbound and outbound calls to engage providers and members to verify clinical information/discharge date and admission status throughout the dayDocuments calls and attaches clinical information receivedRequests clinical information from providers/facilitiesCreates and sends out written correspondenceCreates and distributes determination lettersCollaborates with multiple roles/departments/providers/team members* REMINDER: ATTACH A COPY OF YOUR RESUME *In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:Medical BenefitsDental BenefitsVision BenefitsHealth Savings AccountsFlex Spending AccountsLife Insurance401(k)PTO including 8 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being timeAnd moreUse your skills to make an impactRequired Qualifications1 or more years administrative or technical support experienceExcellent verbal and written communication skillsWorking knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systemsMust 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 10Mx1MMust be passionate about contributing to an organization focused on continuously improving consumer experiencesPreferred QualificationsProficient utilizing electronic medical record and documentation programsProficient and/or experience with medical terminology and/or ICD-10 codesBachelor's Degree in Business, Finance or a related fieldPrior member service or customer service telephone experience desiredExperience with Utilization Review and/or Prior Authorization, preferably within a managed care organizationAdditional InformationScheduled Weekly Hours40Pay RangeThe 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.$37,200 - $51,200 per yearDescription of BenefitsHumana, 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 usHumana 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 EmployerIt 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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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