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Lumeris

Value-based care management via PHSO platform

Health Plan Concierge 1

Customer SuccessPosted on Nov 13
Full-time$39k - $48.1k

About the Job

Requirements

  • A high school diploma, GED, or equivalent experience is required.
  • At least 1 year of high-quality customer service experience in healthcare is required.
  • Experience in healthcare, health insurance, Medicare Advantage, member services, or a metrics-driven contact center is required.
  • Strong verbal and written communication, active listening, emotional intelligence, and relationship-building skills are required.
  • Sound judgment, critical thinking, problem-solving, organization, and the ability to manage multiple priorities are required.
  • Comfort navigating multiple systems accurately and with attention to detail is required.
  • Dependability, independent work habits, schedule adherence, flexibility, and openness to coaching and continuous learning are required.
  • Commitment to HIPAA compliance, organizational privacy policies, and professional accountability is required.
  • Ability to work an 8-hour schedule Monday through Friday between 8 a.m. and 6 p.m. Central Time is required; overtime and weekends may occasionally be required based on business needs.

Responsibilities

  • Conduct outbound engagement and retention campaigns and provide inbound support through phone, email, and in-person interactions as needed.
  • Adapt to changing operational priorities, including inbound and outbound assignments, and identify opportunities to improve processes and member experiences.
  • Educate members on plan benefits, preventive care, digital tools, programs, and available resources, and identify opportunities to offer meaningful assistance.
  • Research and resolve member inquiries, including complex concerns, using sound judgment, appropriate escalation, follow-through, and a focus on First Call Resolution.
  • Manage conversations efficiently while balancing empathy, member needs, Quality standards, productivity, and timely, accurate documentation.
  • Navigate multiple systems and knowledge resources to support accurate responses and effective member service.
  • Collaborate with teammates and cross-functional partners, and support webinars, community events, and other member engagement initiatives.

Desired Qualifications

  • Experience with outbound outreach, retention, service recovery, or member education is preferred.
  • Familiarity with one or more of DASH, Genesys, Microsoft Office, Smartsheet, Jiva, and Zelis is preferred.
  • Openness to using and learning artificial intelligence for solutions and workflows is preferred.
  • A bachelor's degree is a plus but not required.
  • Bilingual ability is a plus.

About the Company

Lumeris

Value-based care management via PHSO platform

Lumeris provides value-based care management as a services operator for health systems and physician groups, offering technology, services, and risk management to shift from fee-for-service to value-based models. Its Population Health Services Organization (PHSO) combines an AI-powered platform called Tom with workflows and expertise to coordinate care, surface best next actions like screenings, and reduce administrative burden. It differentiates itself through risk-sharing partnerships with providers and payers and by leveraging Essence Healthcare’s proven value-based care approach at scale, managing over $13 billion in medical spend and serving more than a million patients. Its goal is to expand the adoption of value-based care by forming broader risk-based partnerships that improve clinical outcomes while controlling costs.

Company size
1,001-5,000
Company stage
Late Stage VC
Total funding
$507M
Headquarters
Maryland Heights, MO
Founded
2001

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