Lumeris
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 Care Manager (Remote) MO & IL Position Summary: The Complex Care Manager at Lumeris will provide telephonic care and care management to Medicare members as part of a multidisciplinary care team. The Complex Care Manager will offer members health and disease education and empower them to actively participate in their care. Other duties of the Complex Care 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.
Qualifications: Current licensure in good standing as a registered nurse in the state of Missouri and/or 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 care 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 care management certification (CCM) within 2 years of hire Must maintain CCM certification during employment Previous experience as a telephonic care manager for a Medicare insurance plan preferred Care management certification preferred BSN or experience with telephonic care management preferred Working Conditions: While performing the duties of this job, the employee works in normal office working conditions.
Make outbound calls to assess memberās 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
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