Utilization Management Coordinator

Become a part of our caring community Humana is seeking a Utilization Management (UM) Coordinator to join the Wisconsin Medicaid Market (iCare) team. Reporting to the UMPA Administrative Supervisor, you will provide non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. Join this dedicated team and lead change in how health care for the underserved in Wisconsin is managed. Process and document all incoming inpatient and outpatient prior authorization (PA) requests as outlined by Humana policies and procedures. Contact providers via phone or fax to request additional information or clarification as needed per established process. Conducts inbound and outbound calls. Work with customers/providers, both internally and externally, regarding the status of PA requests. Take phone calls from providers regarding status of PAs. Enter PA requests into the prior authorization database (TruCare), prepare documentation, and tasks to the appropriate staff member for clinical review. Multi- tasking consistently throughout the day to meet the needs of multiple stakeholders. Use your skills to make an impact Required Qualifications One (1) year of experience working in a health care setting or health plan setting. 1-2 years of experience working in Microsoft Office software applications, specifically Word, Excel, and PowerPoint. 1 year of customer service experience with either inbound and outbound phone calls. Work the