Utilization Management Administration Coordinator - SNF

Humana Inc.

Job Overview

Location

Remote Nationwide

Job Type

Full-time

Full Job Description

📋 Description

• The Utilization Management Administration Coordinator (UMAC) provides essential non-clinical administrative support to ensure members receive the most appropriate treatment, care, or services within Humana’s Skilled Nursing Facility (SNF) segment, directly contributing to care quality, compliance, and operational efficiency in a fully remote role.
• Day-to-day responsibilities include managing NLP (Natural Language Processing) tasks for chart reviews to support nursing teams, building and pending authorizations for clinical review, conducting inbound and outbound calls to providers and members to verify clinical information, discharge dates, and admission status, and meticulously documenting all interactions while attaching received clinical data.
• The role involves proactively requesting clinical information from providers and facilities, creating professional written correspondence, generating and distributing determination letters, and collaborating across multiple departments, roles, and external partners to ensure seamless utilization management workflows.
• As part of Humana’s Home Solutions organization, you will work within a mission-driven team focused on improving health outcomes for Medicare and Medicaid members, leveraging partnerships with CenterWell and Onehome to deliver integrated care solutions in the SNF space.
• This role offers the opportunity to develop deep expertise in utilization review processes, healthcare administration, and medical documentation while building proficiency in healthcare systems, terminology (including ICD-10), and data-driven environments—skills that are highly transferable and valuable for long-term growth in healthcare operations, prior authorization, or care coordination roles.

🎯 Requirements

• 1+ years of experience in an administrative support capacity
• Proficiency in Microsoft Word, Outlook, and Excel with strong data entry and typing skills
• Ability to learn and adapt to new systems (proficient to advanced level)

🏖️ Benefits

• Competitive annual pay range of $40,000–$52,300 for full-time (40 hours/week) remote work
• Comprehensive benefits package including medical, dental, vision, 401(k) retirement savings, paid time off, parental and caregiver leave, disability coverage, and life insurance
• Work-from-home support: Humana provides telephone equipment and offers bi-weekly internet stipends for eligible employees in CA, IL, MT, and SD; requires minimum 25 Mbps download / 10 Mbps upload internet speed

Skills & Technologies

Remote

$40k-52k

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Humana Inc.

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About Humana Inc.

Humana Inc. is a for-profit health and well-being company headquartered in Louisville, Kentucky. Founded in 1961, it provides health insurance, Medicare Advantage plans, Medicaid services, pharmacy benefit management, and clinical care through primary care centers. Serving millions of members across the United States, Humana focuses on integrated care delivery, home health, and wellness programs aimed at improving health outcomes and reducing costs for individuals, employers, and government partners.

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