Manager, UM Administration

Become a part of our caring community and help us put health first
 

Ready to take the next step in your career? Humana is looking for a Manager, UM Administration to join our team! In this role, you’ll use your technical know-how to tackle a variety of challenges while following established processes. You’ll set your own approach, organize resources, and work toward clear goals—making a real impact on our utilization management efforts. If you’re eager to bring your skills to a supportive team and help shape healthcare solutions, we’d love to hear from you. Apply today and see what you can achieve at Humana!

Key responsibilities:

• Provide non-clinical support for policies and procedures, including creating service authorizations
• Offer customer support for authorization inquiries and claim-related issues
• Make decisions related to resources, approaches, and tactical operations for projects and initiatives within your department
• Collaborate across departments and maintain frequent contact with other managers
• Conduct briefings and area meetings to ensure alignment and communication across teams
• Supervise and lead 3 units within your area, providing people management and support
• Identify inefficiencies and opportunities, develop business process improvement plans, and leading the implementation
• Conduct strategic planning efforts

Use your skills to make an impact
 

Required Qualifications

• Bachelor's Degree
• Two years of supervisory or people leadership experience
• Prior demonstrated experience with process improvement or process design and implementation roles
• Must be available to work the hours of 8am to 4:30pm CST, Monday through Friday
• Comprehensive knowledge of all Microsoft Office applications
• Progressive experience in the health service industry, healthcare finance or healthcare related consulting
• Deep understanding of strategic planning, customer loyalty and retention programs, and primary and secondary research processes
• Strategic thinking and business planning capabilities; organized and detail-oriented
• Excellent written and verbal communication skills
• Demonstrated presentation skills

Preferred Qualifications

• Master's Degree
• 3 - 5 years of Utilization Management experience
• Reside within the State of Wisconsin
• General understanding of economic, financial and operational concepts

Additional Information

• Workstyle: Home: Associates Home office environment is their primary work location, but they will use Humana office space on an as needed basis for collaboration and other face-to-face needs.

• Work Location: Wisconsin

• Typical Work Days/Hours: Monday through Friday, 8:00 am – 4:30 pm CST.

• Travel: Monthly or quarterly in person meetings in WI

WAH Internet Statement

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.

• Satellite, cellular and microwave connection can be used only if approved by leadership.

• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.

• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

HireVue

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

SSN Alert

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$86,300 - $118,700 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 

About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.

About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.