Qureos Mentor

Luminare Health

<div>At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
<h1 class="jobSectionHeader">Job Summary
</h1>This position is responsible for the day-to-day operations of the Healthcare Management Program and the analysis of as it relates to the Utilization Management Process.
Required Job Qualifications:
Education:
<ul><li>Active unrestricted Registered Nurse or Practical Nurse License issued by a state or territory of the
</li></ul>United States of America
Experience:
<ul><li>Nurse with a minimum of two years clinical nursing and/or managed care experience
</li></ul>General Abilities/Competencies:
<ul><li>Communicate in a positive and effective manner in both oral and written communication;
</li><li>Read and interpret documents, criteria, instructions, and policy &amp; procedure manuals;
</li><li>Write/create routine correspondence and reports;
</li><li>Speak effectively with clients, physicians, providers, families in crisis and community
</li></ul>agencies as well as co-workers and senior management;
<ul><li>Add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals;
</li><li>Compute rate, ratio and percent;
</li><li>Apply common sense understanding to carry out instruction furnished in written, oral or diagram form;
</li><li>Deal with problems involving several concrete variables in standardized situations;
</li><li>Evaluate problems, develop alternative solutions and identify trends and patterns;
</li><li>Capable of working in an environment that requires organization and prioritization in order to address time sensitive assignments;
</li><li>Excellent interpersonal skills;
</li><li>Perform multiple tasks simultaneously;
</li></ul>Preferred Job Qualifications:
Experience:
&#61623; Prior Utilization Management or Case Management experience preferred
Must live in the follow states:
Illinois, Montana, New Mexico, Oklahoma, Texas, Indiana, Missouri , Wisconsin, Iowa, Kansas, North Carolina, and Pennsylvania
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
<h2 class="jobSectionHeader">EEO Statement:
</h2>We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Pay Transparency Statement:
At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates . 
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
Min to Max Range:
$56,700.00 - $106,400.00</div>

UM Coordinator - LHB

<div>At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
<h1 class="jobSectionHeader">Job Summary
</h1>Job Summary
 
 
The Senior Manager of HCM Operations is responsible for management, and execution of a wide scope of operational processes and workflows, to include support and leadership for all HCM administrative services, customer service/triage of authorization, including HCM system administration. Collaborate with all HCM functional areas to review, revise and implement current/potential new business processes and provide recommendations for new or enhanced solutions, including but not limited to hardware and software, that support current and future HCM operations demand. This role will require active participation in developing and managing project plans, creation and/or updating of Standard Operating Procedures (SOP), outlining tasks to be completed, timeframes, and dedicated resources needed to complete daily/weekly/monthly/quarterly/annual duties. This position requires sound operational management ability.
<h1 class="jobSectionHeader">Minimum Requirements
</h1>Education:
<ul><li>Bachelor&rsquo;s degree and 5 years of relevant experience OR 9 years of relevant experience.
</li></ul>Experience
<ul><li>Minimum of 3 years&rsquo; experience in call center environment
</li><li>Minimum of 2 years&rsquo; experience in leadership/management
</li></ul>General Abilities/Competencies:
<ul><li>Read and comprehend documents, criteria, instructions, and policy and procedure manuals.
</li><li>Speaks effectively with clients, physicians, providers, and members.
</li><li>Evaluate and solution problems, develop alternative models and identify trends and patterns.
</li><li>Ability to prioritize efforts when faced with tight deadlines and multiple, complex projects.
</li><li>Ability to travel to regional field offices and Home Office
</li><li>A demonstrated ability to think/work/prioritize independently.
</li><li>Effective verbal and written communication skills, including the ability to translate technical language to non-technical listeners.
</li><li>Proven management experience with the ability to motivate, organize, direct and evaluate other professionals and support diverse staff while fostering creativity and innovation in the workplace .
</li><li>A demonstrated ability to adapt, quickly learn new skills and serve as a sponsor of change
</li></ul><h1 class="jobSectionHeader">Preferred Requirements
</h1>Education:
<ul><li>Medical Coding Certification
</li></ul>Experience:
<ul><li>Previous experience in a healthcare or insurance environment
</li><li>Three years of TPA (Third Party Administration) management experience.
</li></ul>Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
<h2 class="jobSectionHeader">EEO Statement:
</h2>We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Pay Transparency Statement:
At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates . 
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
Min to Max Range:
$56,700.00 - $106,400.00</div>

Sr Mgr HCM Operations - LHB

<div>At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
<h1 class="jobSectionHeader">Job Summary
</h1>Responsible for the overall relationship with the client, starting at implementation and continuing through everyday problem resolution and renewal activities. Works directly with sales executives during finalist presentations and may be asked to present to potential clients. Expected to support and service between 12 &ndash; 20 groups of clients between $50,000 - $250,000+ annual net revenue. Maintains senior management level contact with Benefits, Human Resources, and financial staff of the client. Also responsible for the service delivery of Luminare Health products and services that ensure client satisfaction. May have some internal project participation. Charged with retaining and growing their assigned book of business, but also supporting their Regional Team as needed.
Required Job Qualifications:
<ul><li>High school diploma or GED equivalent required
</li><li>3-5 years previous experience of Client Management experience and/or experience in a similar TPA or insurance environment with client facing/client support responsibilities
</li><li>Results oriented and self-motivated
</li><li>Excellent written and verbal communications skills are required, as are exceptional organizational skills
</li><li>Ability to interact with senior level executives
</li><li>Thorough understanding of self-funding and employee benefit plans; stop loss understanding a plus; Knowledge and understanding of benefit-related federal laws (i.e., ERISA, COBRA, HIPAA,PPACA, etc.)
</li><li>Excellent presentation skills
</li><li>Analytical skills, problem solving skills, reading ability, creative decision-making skills, the ability to comprehend and follow instructions, mathematical ability and time management skills are required
</li><li>Experience with PowerSTEPP
</li><li>Ability to travel is required
</li></ul>Preferred Job Qualifications:
<ul><li>College degree
</li><li>State insurance license
</li></ul>Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
<h2 class="jobSectionHeader">EEO Statement:
</h2>We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Pay Transparency Statement:
At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates . 
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
Min to Max Range:
$66,300.00 - $124,500.00
Exact compensation may vary based on skills, experience, and location.</div>

Client Manager - LHB

Join Luminare Health and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Luminare Health

ABOUT_COMPANY

UM Coordinator - LHB

Sr Mgr HCM Operations - LHB

Client Manager - LHB