Become a part of our caring community and help us put health first
Join the IL Medicaid Utilization Management (UM) team as a UM Administration Coordinator, reporting to the UM Administration Supervisor, where your work directly impacts the quality of care for our members. In this role, you will collaborate with other professionals, contribute to the smooth administration of utilization management processes, and handle an array of administrative and operational tasks. Use your skills to help ensure members receive the most appropriate treatment and services.
- Provide non-clinical support for policies and procedures ensuring the best and most appropriate treatment, care or services for members.
- Review cues, reports, and outlook inboxes for information from providers to build authorizations for services for dual eligible members.
- Use a variety of both Humana and State of Illinois programs and websites to review member information and eligibility.
- Make decisions focused on interpretation of department policy and methods for completing assignments.
- Follow standard policies and practices that allow for some opportunity for interpretation or independent decisions.
Use your skills to make an impact
Required Qualifications
- Must reside in the Greater Chicago area/suburban Cook or nearby surrounding counties in the State of Illinois.
- 2+ years of experience in the healthcare industry.
- Previous experience working with Medicaid, Long Term Care, or Medicare.
- Experience with Microsoft Office programs specifically Word, Excel, Outlook.
Preferred Qualifications
- Associate's degree.
- Prior billing/claims or authorization experience.
- Experience using electronic medical record and documentation programs.
- Experience with medical terminology and ICD-10 codes.
- Experience with Utilization Review or Prior Authorization, preferably within a managed care organization.
Additional Information
- Schedule: Monday through Friday, 8:00 AM – 5:00 PM CST
- Work Location: Schaumburg, IL
- Work Style: Hybrid Home. You will be required to come into the Schaumburg, IL office once per month.
Work-at-Home (WAH) Internet Statement
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if approved by leadership.
- Employees who live and work from Home in the state of 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.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Interview Format
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Scheduled Weekly Hours
40
Pay Range
The 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.
$44,000 - $57,500 per year
Description of Benefits
Humana, 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 Us
Humana 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 Employer
It 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.
