Business Analyst focusing on digital projects, identifying business needs, facilitating communication, and supporting application activities. Evaluating internal controls and preparing audit reports.
About the role
- UM Administration Coordinator providing non-clinical utilization management support for Humana's Kentucky Medicaid plan; performs administrative tasks and documentation
Responsibilities
- Contribute to administration of utilization management for Humana’s KY Medicaid plan
- Provide non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members
- Perform varied activities and moderately complex administrative/operational/customer support assignments
- Perform computations and work on semi-routine assignments
- Interpret area/department policy and methods for completing assignments with some latitude over prioritization and timing
- Work under minimal direction following standard policies/practices with opportunity for independent discretion
- Occasional travel to Humana's offices for training or meetings may be required
Requirements
- 1+ year of administrative or technical support experience
- Excellent verbal and written communication skills
- Working knowledge of MS Office including Word, Excel, and Outlook in a Windows based environment and an ability to quickly learn new systems
- Proficient utilizing electronic medical record and documentation programs (preferred)
- Proficient and/or experience with medical terminology and/or ICD-10 codes (preferred)
- Bachelor's Degree (preferred)
- Prior member service or customer service telephone experience (preferred)
- Experience with Utilization Review and/or Prior Authorization within a managed care organization (preferred)
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
- Minimum home internet: download speed of 25 Mbps and upload speed of 10 Mbps; wireless, wired cable or DSL suggested; satellite, cellular and microwave require leadership approval
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
- Humana offers many other opportunities
- Employees who live and work from Home in 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 employees with telephone equipment appropriate to meet the business requirements for their position/job
Job title
Job type
Experience level
Salary
Degree requirement
No Education Requirement
Location requirements
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