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Non-Clinical Utilization Management Specialist - Part time Weekends - (Role Number: 185694)

01/11/2018Call Center
Job Location:
Overland Park, KS
Metro Area:
KS - Kansas City
Company Name: Humana Inc.
Website:  Click to Visit
Role: Non-Clinical Utilization Management Specialist - Part Time Assignment: Medicare Location: Work at Home   Humanas dream is to help our members and our own associates achieve lifelong well-being.  Use your clinical experience to work with patients and providers in a nontraditional environment where your knowledge will make a difference.  Our associates know their work is vitally important; we strive to ensure we provide perfect service with one-on-one member interactions as a coach, personal nurse, or clinical advisor. Humanas Perfect Service means getting the basics done right, delivering value and quality, providing guidance on needs, and being engaged with our members.  We want to help our members make the right choices to live life fully. We begin that process by connecting our members with an associate who cares.   Assignment Capsule Be a part of our Clinical Space- Provide guidance to facilitate interaction or services that connect people with lifelong well-being.   As a Clinical Innovations Specialist you will contribute to the success of Humanas business strategy by collecting broad based information and gathering resources and data in order to arm the team with the tools necessary to enhance consumer engagement, choice, and trust.
  • Make outbound calls to engage members and/or providers to verify clinical information
  • Document all calls and attach clinical information received
  • Create and send out written correspondence
  • Hours:  Saturday,Sunday, and 1 weekday 8:00 a.m. - 5:00 p.m. Central
Key Competencies
  • Accountability:  Meets established expectations and takes responsibility for achieving results; encourages others to do the same.
  • Builds Trust:  Consistently models and inspires high levels of integrity, lives up to commitments, and takes responsibility for the impact of one's actions.
  • Collaborates:  Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Humana's overall success first.
  • Customer Focus:  Connects meaningfully with customers to build emotional engagement and customer advocacy.  Simplifies complexity and integrates internal efforts to deliver an optimal customer experience. 

Role Essentials
  • High School Diploma
  • Proficiency in all Microsoft Office applications, including Outlook, Word and Excel
  • Excellent communication skills, both verbal and written
  • Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems
  • Must have a separate space that can be used as a home office to ensure you and your members have absolute and continuous privacy while you work
  • Must provide a high speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role).  A minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required


Role Desirables

  • Associates or Bachelors Degree in Business, Finance or a related field
  • Familiarity with medical terminology and/or ICD-10 codes
  • Proficiency with CGX
Reporting Relationships You will report to a Front Line Leader.   Additional Information     Humana is an organization with careers that change livesincluding yours.  As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives.  If youre ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.   Apply now, or join our Talent Network so you can stay informed and up to date on whats happening at Humana.
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