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Case Manager

Role overview

Qualifications

  • Associate's Degree in Nursing
  • Active RN License required
  • Minimum three years of clinical care required
  • Active CCM Certification or the ability to obtain CCM certification within 18 months of hire date

Responsibilities

  • Acts as the liaison between a patient, the primary care physician and other providers in the healthcare community
  • Assesses, plans, implements, coordinates, monitors, and evaluates the options for patient care
  • Works independently and completes tasks in a timely manner, reprioritizing workload to meet customer needs
  • Engages in excellent communication in verbal and written form

Key facts

Other skills

  • Problem Solving
  • Time Management
  • Organizational Skills
  • Customer Service
  • Critical Thinking
  • Communication
  • Microsoft Word
  • Microsoft Excel
  • Microsoft Outlook
  • Social Skills

About the company

Health Care Service Corporation logo

Health Care Service Corporation

Health Insurance (Payers)

Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), is an Independent Licensee of the Blue Cross and Blue Shield Association. We are the largest customer-owned health insurer in the United States, serving more than 18.6 million members through our Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. For nearly a century, we have enabled and coordinated the access to quality care for millions of members. Our experience and industry knowledge establishes a solid foundation for our future—driving innovations that further expand access, improve health outcomes, and reduce costs. Embedded within the fabric of how we operate is a deep sense of caring and commitment that informs how we serve our members, engage in local communities, and deliver positive change to the health care industry. As health care needs evolve, we leverage our portfolio of companies to deliver differentiated value to all industry stakeholders so that, together, we make more possible. Join HCSC and discover what new ways of thinking can mean for you, your community, our customers and our organization: HCSC.com/careers. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to an inclusive, drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability, or protected veteran status.

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

At Luminare Health, our people are what set us apart. Their expertise, dedication, and passion for service excellence are the foundation of our success.


We're committed to helping our employees grow through thoughtful development opportunities, meaningful work, and a culture that values collaboration and continuous improvement. When you join Luminare Health, you join a purpose-driven team focused on making healthcare simpler, better, and more affordable.

Job Summary

The Case Manager acts as the liaison between a patient, the primary care physician and other providers in the healthcare community. The Case Manager assesses, plans, implements, coordinates, monitors, and evaluates the options.

**Work Schedule: Scheduled hours will fall within 8:00 AM – 6:30 PM CST, depending on client needs in the Mountain and Pacific regions**

Required Job Qualifications:

  • Associate's Degree in Nursing

  • Active RN License required

  • Minimum three years of clinical care required

  • Active CCM Certification or the ability to obtain CCM certification within 18 months of hire date

  • Demonstrated problem solving skills

  • Possess strong time management and organizational skills

  • Ability to work independently and complete tasks in a timely manner, reprioritizing workload to meet customer needs

  • Excellent customer service skills

  • Ability to work in a fast-paced, customer service driven environment

  • Ability to accurately document system notes while engaging callers

  • Ability to provide excellent communication in verbal and written form

  • Ability to read and interpret documents, criteria, instructions, and policy and procedure manuals

  • Excellent interpersonal skills

  • Ability to add, subtract, multiply and divide using whole numbers, common fractions and decimals

  • Ability to effectively communicate with employees, employers, physicians, families in crisis, community agencies and all levels of leadership 

  • Ability to use commonsense understanding to carry out instructions furnished in written, oral or diagram form 

  • Ability to use critical thinking skills to deal with problems in varying situations and reach reasonable solutions

  • Proficient in MS Word, Excel and Outlook

Preferred Job Qualifications:

  • Bachelor of Science in Nursing preferred

  • Case Management or Utilization Management in physical and mental health experience preferred

  • Third-Party Administrator, Managed Care or health insurance experience

  • Bilingual

** Remote employees must live within the continental United States, excluding  Alaska, New York, California, or Hawaii. **

#LI-NR1

LI-Remote

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 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:

$57,800.00 - $108,500.00

Exact compensation may vary based on skills, experience, and location.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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