Utilization Mgmt. Coordinator

Become a part of our caring community At Humana , we work collaboratively to provide solutions and fulfill our commitment to serving members. The UM Administration Coordinator role supports UM operations through provider/member-facing phone support and back-office administrative responsibilities. As a UMAC 2, you will report to the Supervisor, UM Management, and support UM processes while working remotely. Schedule: 8-hour shifts ending no later than 7:00pmCST/8:00 PM EST, including one weekend day (Saturday or Sunday) and holiday rotation. Scheduled breaks and meal periods are assigned to ensure adequate staffing and maintain service levels for providers and members. Training Schedule The first month consists of mandatory training conducted Monday through Friday from 8:00 AM to 4:30 PM CST Key Responsibilities As a Utilization Management Administration Coordinator, you will: Handle inbound and outbound calls about prior authorizations, utilization management services, and benefits; help providers and members navigate these processes, with approximately 30 to 50 phone interactions daily when assigned to phone support. Process and review prior authorization requests and documentation, researching and evaluating information to support medical necessity determinations and authorization workflows. Perform back-office administrative tasks, including case research, record updates, error resolution, and timely case processing. Review, verify, and enter accurate information across mu