Bilingual Compliance UM Coordinator

Humana

. Review utilization management activities and documentation for adherence to policies, procedures, and regulations .

Posted 10/28/2026full-timeRemote • United StatesJunior💰 $43,000 - $56,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates proficiency in utilization management activities, data analysis, and adherence to healthcare regulations while ensuring the protection of member PHI/HIPAA information. Capable of working independently and collaboratively in an agile environment with strong communication skills.

Highest-signal resume keywords

Utilization Management ExperienceData Analysis SkillsBilingual in English and SpanishProficient in Microsoft Word and ExcelHealthcare Compliance Knowledge

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Utilization ManagementData AnalysisMedical TerminologyICD-10 CodesAuditingComplianceQIO Appeals ProcessingExpedited Requests ProcessingAttention to DetailTechnical Experience

Soft Skills

Excellent Communication SkillsAbility to Work IndependentlyTeam CollaborationStrong Attention to DetailProblem-Solving Skills

Tools & Technologies

Microsoft WordMicrosoft ExcelHigh-Speed DSLCable Modem Internet

Industry Keywords

HealthcarePHIHIPAAConsumer ExperienceAgile Environment

About the role

Key responsibilities & impact

Review utilization management activities and documentation for adherence to policies, procedures, and regulations
Collect and analyze daily, weekly, monthly, or ad hoc data to assess team and individual outcome and operational metrics
Interpret guidelines and independently determine appropriate courses of action
Process QIO fast-track appeals and expedited authorization requests according to established guidelines and regulatory turnaround times
Follow department, segment, and organizational strategies and operating objectives
Make decisions regarding work methods in occasionally ambiguous situations
Work with minimal direction and receive guidance where needed
Protect member PHI/HIPAA information while working from home

Requirements

What you’ll need

1–3 years of technical experience
Proficient in Microsoft Word and Excel
Strong attention to detail and accuracy
Passion for contributing to an organization focused on continuously improving consumer experiences
Excellent verbal and written communication skills
Clerical support background in a healthcare environment
Ability to work independently in an agile environment under general instructions and within a team
Bilingual in English and Spanish with full professional proficiency; able to successfully pass required examinations
Ability to work schedules between Monday and Sunday, 8 am to 8 pm EST
Ability to provide high-speed DSL or cable modem internet for a home office; satellite and wireless internet are not allowed
Minimum internet speed of 25 Mbps download and 10 Mbps upload
Dedicated office space without ongoing interruptions to protect member PHI/HIPAA information
UM experience with auditing or compliance (preferred)
UM experience processing expedited requests or QIO appeals (preferred)
Familiarity with medical terminology and/or ICD-10 codes (preferred)
Associate's or Bachelor's degree in Healthcare, Business, Finance, or related field (preferred)

Benefits

Comp & perks

Medical, dental, and vision benefits
401(k) retirement savings plan
Paid time off
Company and personal holidays
Paid parental and caregiver leave
Short-term and long-term disability
Life insurance
Flexible schedule
Four-day workweek with ten-hour shifts
Occasional overtime
Remote work arrangement
Training and meetings travel opportunities