The UM Coordinator 2 collects and analyzes data daily, weekly, monthly or as needed to assess outcome and operational metrics for the team and individuals. Collects and analyzes data daily, weekly, monthly or as needed to assess outcome and operational metrics for the team and individuals. Ensures mandatory reporting completed. 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.
Preferred applicants will have a clerical support background in a healthcare environment (Certified Nurse Aide, Medical Assistant, or medical coding is valuable), possess excellent phone etiquette, communication skills and demonstrate proficiency with MS Office products; particularly Word, Excel and Outlook. This role requires mandatory Saturdays and Sundays with two days off during the week. Business hours are 8 am- 5 pm Mountain Time, however hours may vary based on schedule rotation and business need.
Make outbound calls to engage members and/or providers to verify clinical information.
Document all calls and attach clinical information received.
Create and send out written correspondence.
Must be able to meet passing phone and documentation audit scores.
Must be able to meet standard metrics.
Must be a team player. Frequent collaboration will occur between nurses and medical directors.
Must be able to work with flexible scheduling and a demanding environment.
- High School Diploma or equivalent
- 1+ years of medical/healthcare or related administrative experience
- Proficiency in Microsoft Office applications, including Word, Excel and Outlook
- Excellent verbal and written communication skills
- Must have accessibility to high speed DSL or Cable modem for a home office (Satellite internet service is NOT allowed for this role); and recommended speed for optimal performance for Humana systems is 10Mx1M
- Ability to provide a designated workspace; free from distractions with the ability to secure any protected information.
- Associates working in the state of Arizona must comply with the Tobacco Free Hiring Policy (see details below under Additional Information) and upon offer will be subjected to nicotine testing as part of a 10 panel drug test
- CO, AZ or NM residence preferred
- Associate's or Bachelor's Degree in Business, Finance or a related field
- Clerical support background in a healthcare environment
- Familiarity with medical terminology and/or ICD-10 codes
- Experience working in a call center environment a plus
- CNA or Medical Assistant background a plus
The following policy applies ONLY to associates working in the state of Arizona: Humana is committed to providing a safe and healthy work environment and to promoting the health and well-being of its associates. Effective April 1, 2011, Humana has adopted a tobacco-free hiring policy that will promote a healthier workplace and will not hire users of tobacco and nicotine products. If you have any questions, please consult with your recruiter.
Scheduled Weekly Hours