Dynamic Utilization Management Coordinator at Humana with expertise in regulatory compliance and telehealth coordination. Proven track record in enhancing patient communication and optimizing care services. Skilled in electronic medical records and adept at multitasking in fast-paced environments, ensuring efficient case management and adherence to health plan policies. Detail-oriented and compassionate healthcare support professional with strong experience in utilization management and administrative coordination, known for excellent communication, adaptability, and the ability to build rapport with patients and healthcare teams. Eager to transition into a hands-on Medical Assistant role, leveraging proven skills in healthcare operations, patient support, and clinical documentation.
Healthcare Experience: Humana – Utilization Management Coordinator 2, Louisville, KY • Nov 2019 – Present. Coordinate clinical information and authorization for patient care services. Communicate with providers to obtain necessary documentation for utilization review. Prepare and send letters to members regarding case status and coverage. Triage calls and support resolution of disputes and escalations. Ensure compliance with health plan policies and federal guidelines.