Clinical Advisor

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.

Job SummaryThe Clinical Advisor is responsible for providing day to day client support on behalf of the Health Care Management department. Under the direction of the Senior Director, Clinical Consultant, the primary responsibilities will be to support our members and clients day to day and strategically collaborate with all Healthcare Management and non-Healthcare Management team members to ensure the needs of our clients are met. The Clinical Advisor will strategically collaborate with these teams to ensure our current workflows and processes for Utilization Review and Case Management meet the needs of new and existing clients. The position will have additional responsibility to have active visible presence with internal and external (client facing) clients for management and support for our business needs and growth. The Clinician Advisor will support the Senior Director, Clinical Consultant by maintaining active communication and relationships with all internal and external stake holders in sales, clinical teams, client management, claims, managed care, etc. to deliver solutions and results for our business.

Required Job Qualifications:

Education:

• Associate Degree
• Active State Registered Nursing License

Experience

• Minimum five years’ experience in direct clinical care and/or Minimum of three years’ experience in medical management including case management or utilization management
• Minimum 1 year in healthcare consulting (client facing role or experience in delivery of results to clients)
• Knowledge of Health Care, Industry and Managed Care Delivery systems. This includes current standards of medical practice, insurance benefit structure, related legal/medical issues, utilization management, case management and quality management processes.

General Abilities/Competencies:

• Ability to actively manage and delivery on client expectations around projects, timelines, deliverables, outcomes, etc.
• Experience working with all levels within a client organization
• Excellent oral, written and presentation communication skills with the ability to interact effectively with new and existing clients and other internal clients (ie: claims, client management, senior leadership, etc.)Evaluate problems, develop alternative solutions and identify trends and patterns.
• Deal with problems involving several concrete variables in standardized situation.
• Ability to prioritize efforts when faced with tight deadlines and multiple, complex projects
• Strong organizational skills with attention to detail
• A demonstrated ability to adapt, quickly learn new skills and serve as a sponsor of change
• Maintain high level of confidentiality, flexibility and willingness to learn new tasks and take on new duties as needed
• Critical thinking skills allowing one to carry out instruction furnished in written, oral or diagram form
• A demonstrated ability to think/work/prioritize independently
• Work in a dynamic team-oriented environment
• Write/create routine correspondence and reports
• Read and interpret documents, criteria, instructions, and policy and procedure manuals.
• Ability to travel as needed.
• Demonstrates knowledge of Microsoft Office Suite products.

Preferred Job Qualifications:

• Bachelor of Science in Nursing
• Prior Utilization Management and/or Case Management experience
• TPA or Health Insurance related experience
• Personnel management experience a plus
• Strong consultative and analytical skills

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

EEO Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, 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 Apply