Supervisor, Large Case Management en Lucent Health

About Lucent Health 

Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. 

Company Culture 

We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. 

Honest 

• Transparent Communication: be open and clear in all interactions without withholding crucial information
• Integrity: ensure accuracy in reporting, work outputs and any tasks assigned
• Truthfulness: provide honest feedback and report any issues or challenges as they arise
• Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior

Ethical 

• Fair Decision Making: ensure all actions and decisions respect company policies and values
• Accountability: own up to mistakes and take responsibility for rectifying them
• Respect: treat colleagues, clients and partners with fairness and dignity
• Confidentiality: safeguard sensitive information and avoid conflicts of interest

Hardworking 

• Consistency: meet or exceed deadlines, maintaining high productivity levels
• Proactiveness: take initiative to tackle challenges without waiting to be asked 
• Willingness: voluntarily offer to assist in additional projects or tasks when needed
• Adaptability: work efficiently under pressure or in changing environments

Summary

The Supervisor of Large Case Management is responsible for the daily support and operational performance of the Large Case Management (LCM) team. This role ensures effective case management of high-cost and complex medical cases, promotes quality member outcomes, and maintains compliance with regulatory and contractual requirements. The Supervisor provides leadership, coaching, and clinical support to case management staff while coordinating with internal departments and external vendor partners to optimize case outcomes and financial impact.  Additionally, the Supervisor supports case management vendor referrals and oversight.  The Supervisor reports to the Manager, LCM.  This role may require some intermittent travel.

Responsibilities

• Supervise day-to-day operations of the Large Case Management team, including monitoring productivity, case volumes, timeliness, and quality of documentation.
• Provide guidance, coaching, and performance feedback to case managers and support staff.
• Support Case Management vendor referrals, including clinical review to determine appropriateness of referrals to vendors
• Support preparation, accuracy, and timeliness of monthly and ad hoc stop loss reports, ensuring data integrity and clinical relevance for high-cost claims.
• Ensure all case management activities meet accreditation, regulatory, and contractual standards (e.g., state, federal, URAC, NCQA, HIPAA).
• Support internal and external audits, quality assurance initiatives, and process improvement efforts.
• Communicate effectively with leadership on case management outcomes, trends, and opportunities for improvement.
• Reviews referrals to case management and completes daily assignments 
• Maintains licensure spreadsheet and ensures adequate state coverage based on new clients onboarding
• Collaborates with case management team to resolve complex care member issues
• Maintains knowledge of regulations, accreditation standards, and industry best practices related to case management
• Works with case management team and senior management to identify opportunities for process and quality improvements within case management.
• Educates and provides resources for case management team on key initiatives and to facilitate on-going communication between case management team
• Works with the senior management to develop and implement case management policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services
• Evaluates case management team performance and provides feedback regarding performance, goals, and career milestones
• Provides coaching and guidance to case management team to ensure adherence to quality and performance standards
• Assists with onboarding, hiring, and training case management team members as needed
• Leads and champions change within scope of responsibility
• Performs other duties as assigned

Qualifications

• Registered Nurse with a minimum of 5 years of recent clinical nursing experience. 
• Minimum of 1 year in a healthcare leadership role (e.g. team lead or higher)
• Bachelor’s Degree from an accredited college or university required
• Demonstrated ability to manage and lead a team of direct reports
• Excellent written and oral communication skills
• Strong analytical skills with attention to detail
• Ability to identify areas of improvement and develop action plan to address findings
• Positive, proactive team-oriented approach/attitude 
• Strong knowledge of Microsoft Office products
• Holds a current, active, and unrestricted RN license that allows him/her to practice in a state or territory of the United States. 
• Relevant certifications such as Certified Case Manager (CCM) may be preferred.

Equal Employment Opportunity Policy Statement

Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.