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.

Required Job Qualifications:

• Active unrestricted Registered Nurse License issued by a state or territory of the United States of America
• Certification in MCG or the ability to obtain within 6 months of hire date.
• CCM certification or the ability to obtain CCM certification within 18 months of hire date, if not currently active.
• Minimum of three years clinical experience (medical/surgical, community health nursing, home healthcare nursing).
• Minimum of two years of utilization review and/or case management experience.
• 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 co-workers and senior management.
• Ability to successfully train adult learners and meet the educational needs of those being trained.
• Critical thinking skills allow one to apply common sense to carry out instruction furnished in written, oral or diagram form.
• Evaluate problems, develop alternative solutions, and identify trends and patterns.
• Capable of working in an environment that requires organization and prioritization to address time sensitive assignments.
• Excellent interpersonal skills.
• Must be able to handle multiple priorities in an environment that requires organization and prioritization and the ability to address time sensitive assignments.
• Maintain high level of confidentiality, flexibility, and willingness to learn new tasks and take on new duties as needed.
• Work in a dynamic team-oriented environment
• Work independently with minimal supervision or instruction.
• Demonstrates proficiency with Microsoft Office Suite products.
• Strong presentation and communication skills. Ability to articulate professionally and confidently with internal and external stakeholders.
• Strong ability for clear and concise documentation to meet all legal, privacy, and regulatory requirements.

Preferred Job Qualifications:

• Bachelor of Science in Nursing preferred.
• MCG Certification
• CCM Certification
• Prior project management, supervisory/ leadership, or progressive responsibility and professional experience
• TPA or Insurance related experience
• Prior Training experience

The compensation range for this position is $55,300 - $103,800.The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, sexual identity, age, veteran, or disability.

Pay Transparency Statement:

At Luminare Health, you will be part of an organization committed to offering meaningful benefits to our associates to support their life outside of work. From health and wellness benefits, 401(k) savings plan, a minimum of 15 days' of paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, new parent paid leave, tuition reimbursement, plus other incentives, we offer a robust total rewards package for full-time associates.

The salary offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan.

Min to Max Range: