UM Coordinator - LHB - Work From Home (HB)

Welcome to a team of caring and passionate people who work each day to meet the needs of our members and clients. At Luminare Health (a subsidiary of Health Care Service Corporation), you will be part of an organization committed to offering custom services to self-funded health benefits plans that manage costs – without compromising benefits – by offering innovative solutions, flexibility, transparency and customer support. This is an exciting time to join our team and enhance our culture that emphasizes caring, diversity and inclusion, mutual respect, collaboration and service to our communities. 

Job SummaryThis 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: 

• Active unrestricted Registered Nurse or Practical Nurse License issued by a state or territory of the

United States of America

Experience: 

• Nurse with a minimum of two years clinical nursing and/or managed care experience

General Abilities/Competencies:

• Communicate in a positive and effective manner in both oral and written communication;
• Read and interpret documents, criteria, instructions, and policy & procedure manuals;
• Write/create routine correspondence and reports;
• Speak effectively with clients, physicians, providers, families in crisis and community

agencies as well as co-workers and senior management;

• Add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals;
• Compute rate, ratio and percent;
• Apply common sense understanding to carry out instruction furnished in written, oral or diagram form;
• Deal with problems involving several concrete variables in standardized situations;
• Evaluate problems, develop alternative solutions and identify trends and patterns; 
• Capable of working in an environment that requires organization and prioritization in order to address time …