UM Administration Coordinator

Humana
Trenton, NJ
**Become a part of our caring community and help us put health first** The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments. **Become a part of our caring community and help us put health first** The UM Administration Coordinator 2 provides non-clinical support for the policies and procedures ensuring best and most appropriate treatment, care or services for members. 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. **Key Responsibilities:** + Responsible for intercepting inbound calls and assisting facilities/providers in scheduling and coordinating Peer to Peer discussions + Managing Humana Medical Directors' calendars + Monitoring and decisioning authorizations + Responding to provider inquiries regarding existing authorizations, and providing timely updates as needed via fax or phone calls, ensuring compliance with organizational policies and applicable federal regulations. + Maintaining high-quality standard and meeting monthly quality requirements + Ability in maneuvering multiple systems simultaneously **Core Competencies:** + Communicate ideas and updates clearly to team members, actively listen to feedback and concerns, and facilitate open, honest dialogue. + Collaborate and contribute effectively to team projects and goals, supporting colleagues and resolving issues that impact the team. + Share knowledge, work effectively with cross-functional teams, and coordinate tasks and responsibilities among team members. **Use your skills to make an impact** **Required Qualifications** + 1 or more years' experience working in an administrative support capacity in a healthcare setting + Excellent verbal and written communication skills + Demonstrated attention to detail + Ability to navigate process flows and follow procedure documents + Working knowledge of MS Office including Word, Excel, Teams, and Outlook in a Windows based environment and an ability to quickly learn new systems + Must effectively manage personal responsibilities to ensure a professional work environment conducive to achieving performance goals **Preferred Qualifications** + Proficient utilizing electronic medical record and documentation programs + Prior experience with CGX and Genesys + Prior experience with post-acute authorizations + Prior experience in a metric driven environment + Prior experience in the healthcare industry + Proficient and/or experience with medical terminology and/or ICD-10 codes + Prior member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: ​ + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates 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 associates 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 **Additional Information** + Work hours are Monday-Friday 7am-7pm EST (Your 8-hour shift will fall within this timeframe) + Overtime available based upon business needs + Weekend and/or holiday coverage possible for this role Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **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. $40,000 - $52,300 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. Application Deadline: 11-20-2025 **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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
Posted 2025-11-18

Recommended Jobs

Denial and Appeals Coordinator- Onsite Passaic, NJ

ScionHealth
Passaic, NJ

At ScionHealth , we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and…

View Details
Posted 2025-11-21

Survey Technician

Spotlock
Lakewood, NJ

About Us: We are a leading surveying firm based in Lakewood, NJ, dedicated to providing high-quality surveying services. Our team is committed to precision, innovation, and exceptional service. We…

View Details
Posted 2025-10-17

Lead Design Engineer - Substation/ Power Distribution

Eaton Corporation
Trenton, NJ

Eaton's ES AMER ESS division is currently seeking a Lead Design Engineer. The Lead Design Engineer (LDE) is responsible for leading design deliverables to maintain project schedule, design budget, des…

View Details
Posted 2025-11-15

Server

Olive Garden
Eatontown, NJ

$5.62 per hour - $5.62 per hour plus tips. Our Winning Family Starts With You!  Check out these great benefits! ~ Flexible schedules to help you balance other life commitments (school, chil…

View Details
Posted 2025-07-28

BAR BACK - Prudential Center

Compass Group
Newark, NJ

    Position Title: BAR BACK at Prudential Center Pay Range : $20.25 to $20.25  We Make Applying Easy! Want to apply to this job via text messaging? Text JOB to 75000  and search requisiti…

View Details
Posted 2025-09-04

Construction Reporting Analyst | Hudson Tunnel Project

Platinum Global Talent Solutions Ltd.
Newark, NJ

About the Company & Project Our client is a leading global Consultancy renowned for delivering high-profile, complex, iconic, large-scale capital projects. We are currently seeking a dedica…

View Details
Posted 2025-10-14

Speciality Seller - Energy/Utilities industry (Remote)

NTT DATA North America
Newark, NJ

Req ID: 340249 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organiza…

View Details
Posted 2025-11-20

Youth Soccer Coaches

Gotham FC
Jersey City, NJ

NJ/NY Gotham FC (“Gotham FC” or “the Club”) is a National Women’s Soccer League (“NWSL”) team representing New Jersey and New York. The team plays at Sports Illustrated Stadium in Harrison, NJ. At Got…

View Details
Posted 2025-10-29

Physical Therapist - Home Health Visits

BAYADA Home Health Care
West Orange, NJ

**BAYADA Home Health Care** is currently seeking an experienced **Physical Therapist, PT,** for an opportunity performing **home health visits** for adult and geriatric clients in territories througho…

View Details
Posted 2025-11-17