by Rat Race Rebellion August 7, 2026
About Humana
Humana Inc., a prominent U.S. healthcare company, is dedicated to enhancing the health and well-being of individuals and communities through its comprehensive insurance services and CenterWell healthcare offerings. With a focus on delivering quality care, Humana serves millions of people, including those with Medicare and Medicaid, as well as military personnel and their families.
This is a full-time remote position, offering flexibility and requiring 40 hours per week. The role operates within Eastern Standard Time business hours, with a rotating schedule that includes weekends and holidays. While primarily remote, occasional travel to Humana’s offices for training or meetings may be necessary.
What Your Day Will Look Like
The Compliance (UM) Coordinator will generate notice of adverse benefit determination and approval letters for Medicaid Utilization Management (UM) authorization determinations. The role involves analyzing report data to identify compliance risks, collaborating with teammates for team success, and maintaining production and quality metrics.
Responsibilities & Expectations
- Generate Letters: Issue adverse benefit determinations
- Analyze Data: Identify compliance risk trends
- Collaborate: Work with teammates for success
- Maintain Metrics: Meet production and quality standards
- Ensure Compliance: Adhere to policies and procedures
Relevant Experience & Skills Required
- Education Requirements: High school diploma or GED
- Data Entry Skills: Minimum 1 year required
- Software Proficiency: Microsoft Office Suite
- Healthcare Experience: At least 1 year needed
- Medicaid Knowledge: Utilization Management familiarity preferred
Compensation & Benefits
The compensation for this role is $43,000 – $56,200/yr..
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Before You Apply: Resume Tips for this ATS
Because you are applying directly through the employer’s Applicant Tracking System, your resume needs to be optimized for their software:
- Make sure the words “Compliance,” “Medicaid,” and “Data Entry” appear in your past experience if applicable.
- Highlight any specific experience you have with Microsoft Office applications.
- Ensure your resume clearly states that you are looking for Full-Time work, so the recruiter knows you are aligned with the role.