Utilization Management Coordinator – Home Health

Humana

. Support the administration of utilization management through moderately complex administrative, operational, and customer service tasks .

Posted 11/6/2026full-timeRemote • 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 strong administrative and customer service capabilities, with proficiency in navigating multiple systems and processing information efficiently. Familiarity with utilization management processes and medical terminology enhances the ability to support provider and member interactions effectively.

Highest-signal resume keywords

Utilization Management SupportCustomer Service ExperienceMS Office ProficiencyMedical Terminology KnowledgePrior Authorization Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data ProcessingDocumentation ReviewCalculationsAuthorization Case ProcessingICD-10 Code Familiarity

Soft Skills

Excellent Communication SkillsAdaptabilityPrioritizationAttention to Detail

Tools & Technologies

Electronic Medical Record ProgramsWindows-Based Environment

Industry Keywords

Utilization ReviewManaged Care OrganizationPHI/HIPAA ComplianceInbound Call Handling

About the role

Key responsibilities & impact

Support the administration of utilization management through moderately complex administrative, operational, and customer service tasks
Interact by telephone with providers, members, and other stakeholders
Receive inbound calls and provide customer service
Support intake of utilization management and prior authorization requests
Create and process authorization cases
Generate letters and other correspondence
Triage faxes and shared mailboxes
Process, review, and route documentation
Conduct calculations and data processing
Provide non-clinical support for utilization management policies and procedures
Respond to provider and member questions
Navigate multiple systems while documenting interactions and processing information
Prioritize assignments and work with minimal direction
Adapt between telephonic and non-telephonic functions as business needs and operational priorities change

Requirements

What you’ll need

1 or more years of administrative, technical support, customer service, or related experience
Excellent verbal and written communication skills
Ability and willingness to provide customer service and intake support through high-volume inbound telephone interactions
Ability to simultaneously communicate by telephone, navigate multiple systems/screens, accurately document interactions, and process information
Working knowledge of MS Office, including Word, Excel, and Outlook, in a Windows-based environment
Ability to quickly learn new systems
Accessibility to high-speed DSL or cable modem 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 lacking ongoing interruptions to protect member PHI/HIPAA information
Ability to adapt to changing work assignments based on business and operational needs
Ability to work between 8 a.m. and 8 p.m. EST
Availability for rotational weekend work
Preferred: proficiency with electronic medical record and documentation programs
Preferred: proficiency and/or experience with medical terminology and/or ICD-10 codes
Preferred: Bachelor's degree in Business, Finance, or a related field
Preferred: prior member, provider, call center, or customer service telephone experience
Preferred: experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization

Benefits

Comp & perks

Medical benefits
Dental benefits
Vision benefits
401(k) retirement savings plan
Paid time off
Company holidays
Personal holidays
Paid parental leave
Paid caregiver leave
Short-term disability
Long-term disability
Life insurance
Remote work arrangement
Occasional travel to Humana offices for training or meetings
Dedicated home office space
High-speed home internet requirement/support for remote work