Clinical Advisor

🕒 June 11

🐻 Alaska, California, +2 more states – Remote

🐻 Alaska – Remote 🏄 California – Remote 🌺 Hawaii – Remote 🗽 New York – Remote

💵 $67.6k - $127k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Luminare Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

Healthcare Insurance

Luminare Health is a leading provider of self-funded health plan administration services with over 50 years of industry experience. The company specializes in offering flexible and innovative solutions for hospitals, health systems, and direct-to-employer initiatives, focusing on administration, cost management, and digital reporting tools. Luminare Health is dedicated to being a reliable partner in managing healthcare costs and supporting strategic growth for its clients. The company emphasizes a member-centered approach to healthcare while delivering significant savings through expert claim analysis and management of high-cost claims.

📋 Description

• Provide day to day client support on behalf of the Health Care Management department • Support members and clients day to day and strategically collaborate with all Healthcare Management and non-Healthcare Management team members • Ensure the needs of clients are met • Collaborate to ensure workflows and processes for Utilization Review and Case Management meet client needs • Maintain active communication and relationships with all internal and external stakeholders in sales, clinical teams, client management, claims, managed care, etc. • Deliver solutions and results for business needs and growth

🎯 Requirements

• Associate Degree • Active State Registered Nursing License • Minimum five years’ experience in direct clinical care • Minimum of three years’ experience in medical management including case management or utilization management • Minimum of 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, including current standards of medical practice, insurance benefit structure, related legal/medical issues, utilization management, case management, and quality management processes • Ability to actively manage and deliver 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 • Evaluate problems, develop alternative solutions and identify trends and patterns • Ability to prioritize efforts when faced with tight deadlines and multiple, complex projects • Strong organizational skills with attention to detail • 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 • Demonstrates knowledge of Microsoft Office Suite products.

🏖️ Benefits

• 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 • Other incentives