Utilization Management Coordinator

Humana

. Process and document incoming inpatient and outpatient prior authorization requests according to Humana policies and procedures .

Posted 11/10/2026full-timeRemote • Wisconsin • United StatesJunior💰 $40,000 - $52,300 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in processing and documenting prior authorization requests while ensuring compliance with Humana policies. Proficient in customer service and communication, effectively managing interactions with providers and stakeholders.

Highest-signal resume keywords

Prior Authorization ExperienceCustomer Service SkillsMicrosoft Office ProficiencyTruCare Database ManagementHIPAA Compliance

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

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

Hard Skills

Prior Authorization ProcessingUtilization ManagementData EntryDocumentation PreparationMultitasking

Soft Skills

Effective CommunicationInterpersonal SkillsProblem-Solving

Tools & Technologies

TruCare DatabaseMicrosoft WordMicrosoft ExcelMicrosoft PowerPoint

Industry Keywords

Health Care SettingHealth Plan SettingHealth Insurance EnvironmentPHI ProtectionCST Availability

About the role

Key responsibilities & impact

Process and document incoming inpatient and outpatient prior authorization requests according to Humana policies and procedures
Contact providers by phone or fax to request additional information or clarification
Conduct inbound and outbound calls
Work with internal and external customers/providers regarding prior authorization request status
Take provider calls regarding prior authorization status
Enter prior authorization requests into the TruCare database
Prepare documentation and assign tasks to appropriate staff for clinical review
Multitask throughout the day to meet the needs of multiple stakeholders

Requirements

What you’ll need

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
Ability to work 8:30 am–5:00 pm CST, Monday through Friday, with limited availability for rotated holiday coverage
Reside in the State of WI
Ability to work from a dedicated space without ongoing interruptions to protect member PHI / HIPAA information
Minimum home internet speed of 25 Mbps download and 10 Mbps upload
Preferred: 1 year of experience in prior authorization or utilization management
Preferred: 1 year of experience working in a health insurance environment

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
Remote home workstyle
Occasional use of Humana office space for collaboration and face-to-face needs
Internet service requirements/support for home or hybrid home/office employees
Dedicated workspace for protecting member PHI / HIPAA information
Training and meetings
Occasional travel to Humana's offices for training or meetings