Complex Case Manager (Remote - STL)

Your Future is our Future

At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact.

Position:Complex Case Manager (Remote - STL)

Position Summary:The Complex Case Manager at Lumeris will provide telephonic care and case management to Medicare members as part of a multidisciplinary care team. The Complex Case Manager will offer members health and disease education and empower them to actively participate in their care. Other duties of the Complex Case Manager include but are not limited to: Consultation with members on their medications and durable medical equipment, review member care plans, address home care needs, and connect members to community resources; collaboration with primary care physicians and other providers to ensure there are no gaps in care; collaboration with members, providers, and care givers to ensure positive care outcomes during care transitions.

Job Description:

Primary Responsibilities

• Make outbound calls to assess member’s current health status
• Provide patient education to assist with self-management
• Educate members on disease processes
• Encourage members to make healthy lifestyle changes
• Identify gaps or barriers in treatment plans
• Coordinate care for members
• Make referrals to outside sources
• Coordinate services such as home health, DME, as needed
• Ensure that discharged members receive the necessary services and resources, including medication reconciliation      
• Document and track findings in a computerized system
• Interact with providers and a multi-disciplinary care team
• Collaborate with medical management staff in development of new programs.

*After a period of in-house orientation and contingent on satisfactory work performance, this is a work from home position.

Qualifications

• Current licensure in good standing as a registered nurse in the state of Missouri and Illinois and eligibility for licensure in other states  
• Three years of relevant experience with at least two years minimum experience in a hospital or home health case management setting
• Must be proficient with computers, have the ability to type and talk simultaneously, and have excellent interpersonal and customer service skills, including telephone etiquette. 
• Must be able to multi-task and prioritize on a daily basis
• Must be flexible and adaptive to a changing environment
• Must take and pass case management certification (CCM) within 2 years of hire
• Must maintain CCM certification during employment
• Previous experience as a telephonic case manager for a Medicare insurance plan preferred
• Case management certification preferred
• BSN or experience with telephonic case management preferred

REPORTS TO:  Manager, Case Management

Working Conditions

• While performing the duties of this job, the employee works in normal office working conditions.

Disclaimer

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

Pay Transparency:

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.

The hiring range for this position is:

$72,800.00-$97,400.00

Benefits of working at Lumeris

• Medical, Vision and Dental Plans

• Tax-Advantage Savings Accounts (FSA & HSA)

• Life Insurance and Disability Insurance

• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)

• Employee Assistance Program

• 401k with company match

• Employee Resource Groups

• Employee Discount Program

• Learning and Development Opportunities

• And much more...

Be part of a team that is changing healthcare!

Member Facing Position: No- Not Member or Patient Facing Position

Location:Remote, USA

Time Type:Full time

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.Disclaimer:

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.