SCAN
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Bilingual Spanish RN, Care Management
role at
SCAN .
Acknowledgement: Remote role – California registered nurse required – Monday to Friday 8 am to 5 pm Pacific Time. Bilingual Spanish required.
About SCAN SCAN Group is a not‑for‑profit organization dedicated to tackling the most pressing issues facing older adults in the United States.
SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not‑for‑profit Medicare Advantage plans, serving more than 277,000 members in California, Arizona, Nevada, Texas and New Mexico.
For more than 45 years, SCAN has been a mission‑driven organization focused on keeping seniors healthy and independent, and is recognized throughout the healthcare industry and nationally as a leading expert in senior healthcare.
SCAN employees are talented professionals who are committed to supporting older adults on their aging journey while innovating healthcare for seniors everywhere.
Employees receive in‑depth training, state‑of‑the‑art tools, and opportunities for development and growth.
If you are interested in becoming part of an organization that is innovating senior healthcare, visit www.thescangroup.org or www.scanhealthplan.com, or follow SCAN on LinkedIn, Facebook, and Twitter.
Job Description
Remote role – California RN required – Monday to Friday, 8 am to 5 pm Pacific Time.
Bilingual Spanish required.
The Job Enhance frail seniors’ ability to age in place, manage their health, navigate the health care system, and live independently by providing person‑centered care in accordance with care management, disease management, and complex and enhanced care management programs at SCAN.
The role is an integral part of the care team, working directly with members via telephone to develop and implement plans of care, provide health education and coaching to manage chronic conditions, and prevent exacerbation of symptoms as well as avoidable ER visits and hospital admissions.
You Will
Perform initial and annual telephonic assessments in conjunction with a Community Health Worker for Medi‑Cal/Medicare dually eligible members referred to Care Coordination for Long‑Term Services and Supports (LTSS) and to determine Nursing Facility Level of Care.
Perform nursing‑related Enhanced Care Management (ECM) activities for specific Populations of Focus (POF): Individuals Experiencing Homelessness, Individuals At Risk For Avoidable Hospital or ED Utilization, Adults Living In The Community At Risk Of LTC Institutionalization, Adult Nursing Facility Residents Transitioning Back To The Community.
Ensure the clinical appropriateness of member‑centered care plans by evaluating assessment findings against evidence‑based guidelines, clinical reasoning, and best practices.
Integrate clinical insights and community standards to develop comprehensive and effective care strategies.
Participate actively in interdisciplinary planning and case conference meetings to ensure person‑centered care and that members receive support after discharge from an inpatient or institutional setting.
Build strong working relationships with the Medical Groups team.
Provide education, coaching, and disease management for chronic conditions, identifying new and preventable interventions to avoid exacerbations or worsening conditions.
Promote member engagement and patient activation to ensure optimal self‑management and successful health outcomes.
Demonstrate organizational, decision‑making, critical‑thinking, and multi‑tasking skills that lead to successful member outcomes.
Adhere to all SNP Model of Care requirements and procedures, completing timely and accurate documentation across multiple computer systems.
Comply with all regulatory and quality agency standards, including CMS, DHC, and DHCS.
Actively support the achievement of SCAN’s Vision and Goals.
Perform other duties as assigned.
Your Qualifications
Bachelor’s degree in nursing (BSN) required.
California Registered Nurse (RN) required.
Graduate or advanced degree or equivalent experience preferred.
Bilingual in English and Spanish (testing will be administered if needed).
3+ years of experience in managed care, health care environment, or case management.
2+ years working with seniors and working remotely is strongly preferred.
Leadership skills with the ability to develop others.
Problem‑solving abilities, making critical decisions with high‑level risk assessment.
Strategic mindset, formulating strategy and mapping steps to achieve goals.
Strong interpersonal skills, with excellent written and verbal communication.
Strong organizational and critical‑thinking skills.
Ability to multitask and maintain confidentiality.
General understanding of NCQA standards, CMS and DHCS regulations.
General knowledge of medical terminology and abbreviations.
Deep understanding of local community resources for seniors.
What’s in it for you?
Base salary range: $44.42 to $61.20 per hour.
Remote position.
An annual employee bonus program.
Robust wellness program.
Generous paid‑time‑off (PTO).
Eleven paid holidays per year, plus one floating holiday, plus one birthday holiday.
Excellent 401(k) retirement savings plan with employer match and contribution.
Robust employee recognition program.
Tuition reimbursement.
An opportunity to become part of a team that makes a difference to our members and our community every day.
Seniority Level Mid‑Senior Level
Employment Type Full‑time
Job Function Health Care Provider – Hospitals and Health Care
Equal Opportunity Employer SCAN is proud to be an equal opportunity and affirmative action workplace.
Individuals seeking employment will receive consideration without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, marital status, disability, protected veteran status or any other status protected by law.
A background check is required.
We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.
#J-18808-Ljbffr
Bilingual Spanish RN, Care Management
role at
SCAN .
Acknowledgement: Remote role – California registered nurse required – Monday to Friday 8 am to 5 pm Pacific Time. Bilingual Spanish required.
About SCAN SCAN Group is a not‑for‑profit organization dedicated to tackling the most pressing issues facing older adults in the United States.
SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not‑for‑profit Medicare Advantage plans, serving more than 277,000 members in California, Arizona, Nevada, Texas and New Mexico.
For more than 45 years, SCAN has been a mission‑driven organization focused on keeping seniors healthy and independent, and is recognized throughout the healthcare industry and nationally as a leading expert in senior healthcare.
SCAN employees are talented professionals who are committed to supporting older adults on their aging journey while innovating healthcare for seniors everywhere.
Employees receive in‑depth training, state‑of‑the‑art tools, and opportunities for development and growth.
If you are interested in becoming part of an organization that is innovating senior healthcare, visit www.thescangroup.org or www.scanhealthplan.com, or follow SCAN on LinkedIn, Facebook, and Twitter.
Job Description
Remote role – California RN required – Monday to Friday, 8 am to 5 pm Pacific Time.
Bilingual Spanish required.
The Job Enhance frail seniors’ ability to age in place, manage their health, navigate the health care system, and live independently by providing person‑centered care in accordance with care management, disease management, and complex and enhanced care management programs at SCAN.
The role is an integral part of the care team, working directly with members via telephone to develop and implement plans of care, provide health education and coaching to manage chronic conditions, and prevent exacerbation of symptoms as well as avoidable ER visits and hospital admissions.
You Will
Perform initial and annual telephonic assessments in conjunction with a Community Health Worker for Medi‑Cal/Medicare dually eligible members referred to Care Coordination for Long‑Term Services and Supports (LTSS) and to determine Nursing Facility Level of Care.
Perform nursing‑related Enhanced Care Management (ECM) activities for specific Populations of Focus (POF): Individuals Experiencing Homelessness, Individuals At Risk For Avoidable Hospital or ED Utilization, Adults Living In The Community At Risk Of LTC Institutionalization, Adult Nursing Facility Residents Transitioning Back To The Community.
Ensure the clinical appropriateness of member‑centered care plans by evaluating assessment findings against evidence‑based guidelines, clinical reasoning, and best practices.
Integrate clinical insights and community standards to develop comprehensive and effective care strategies.
Participate actively in interdisciplinary planning and case conference meetings to ensure person‑centered care and that members receive support after discharge from an inpatient or institutional setting.
Build strong working relationships with the Medical Groups team.
Provide education, coaching, and disease management for chronic conditions, identifying new and preventable interventions to avoid exacerbations or worsening conditions.
Promote member engagement and patient activation to ensure optimal self‑management and successful health outcomes.
Demonstrate organizational, decision‑making, critical‑thinking, and multi‑tasking skills that lead to successful member outcomes.
Adhere to all SNP Model of Care requirements and procedures, completing timely and accurate documentation across multiple computer systems.
Comply with all regulatory and quality agency standards, including CMS, DHC, and DHCS.
Actively support the achievement of SCAN’s Vision and Goals.
Perform other duties as assigned.
Your Qualifications
Bachelor’s degree in nursing (BSN) required.
California Registered Nurse (RN) required.
Graduate or advanced degree or equivalent experience preferred.
Bilingual in English and Spanish (testing will be administered if needed).
3+ years of experience in managed care, health care environment, or case management.
2+ years working with seniors and working remotely is strongly preferred.
Leadership skills with the ability to develop others.
Problem‑solving abilities, making critical decisions with high‑level risk assessment.
Strategic mindset, formulating strategy and mapping steps to achieve goals.
Strong interpersonal skills, with excellent written and verbal communication.
Strong organizational and critical‑thinking skills.
Ability to multitask and maintain confidentiality.
General understanding of NCQA standards, CMS and DHCS regulations.
General knowledge of medical terminology and abbreviations.
Deep understanding of local community resources for seniors.
What’s in it for you?
Base salary range: $44.42 to $61.20 per hour.
Remote position.
An annual employee bonus program.
Robust wellness program.
Generous paid‑time‑off (PTO).
Eleven paid holidays per year, plus one floating holiday, plus one birthday holiday.
Excellent 401(k) retirement savings plan with employer match and contribution.
Robust employee recognition program.
Tuition reimbursement.
An opportunity to become part of a team that makes a difference to our members and our community every day.
Seniority Level Mid‑Senior Level
Employment Type Full‑time
Job Function Health Care Provider – Hospitals and Health Care
Equal Opportunity Employer SCAN is proud to be an equal opportunity and affirmative action workplace.
Individuals seeking employment will receive consideration without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, marital status, disability, protected veteran status or any other status protected by law.
A background check is required.
We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.
#J-18808-Ljbffr