Completes through needs assessments and health screens, identifies psychosocial and economic barriers for accessing services and recommend appropriate resources to overcome barriers.
Interacts with members, family, physician(s), case managers and other resources to assess appropriate action needed to address/support medical/psychosocial needs.
Reviews benefits options, researches community resources, coordinates services, trains/creates behavioral routines and enable members to be active participants in their own healthcare.
Participates in case conferences to strategize and develop member specific care plans.
Participates in activities to develop, review or revise new or existing medical management programs as directed.
Identifies and arranges community resources for assistance with psychosocial and/or socioeconomic problem resolution.
Maintains appropriate documentation for all contacts and interventions.
Maintains HIPAA standards and ensure compliance with protected health information.
Reports critical incidents and information regarding safety, elder abuse, and/or quality of care issues to include appropriate agencies, e.g. protective services as appropriate.
Ensures compliance with all state and federal regulations and guidelines in day-to-day activities.
Performs special projects as assigned.
Qualifications
LCSW and MSW required
Licensed in Missouri and/or Illinois, eligible for licensure in other states as required
Minimum of 2 years of clinical experience
Experience in a managed care environment preferred
Computer proficiency
Communicates effectively in person, by phone, and by written communication
Ability to handle multiple assignments and prioritize workload
Working Conditions
While performing the duties of this job, the employee works in normal office working conditions.
#LI-Remote
Pay Transparency
Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.
The hiring range for this position is
$63,600.00-$84,300.00
Benefits of working at Lumeris
Medical, Vision and Dental Plans
Tax-Advantage Savings Accounts (FSA & HSA)
Life Insurance and Disability Insurance
Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
Employee Assistance Program
401k with company match
Employee Resource Groups
Employee Discount Program
Learning and Development Opportunities
And much more...
Be part of a team that is changing healthcare!
Member Facing Position
No- Not Member or Patient Facing Position
Drug Screen Requirement
No
MVR Required
No
Credit Check Required
No
Location
Missouri
Time Type
Full time
Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.
Disclaimer
The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential job duties and responsibilities.
Lumeris is an EEO/AA employer M/F/V/D.
