LTSS Assessment RN (SCAN Temp)

SCAN Health Insurance•Los Angeles, CA

1d•$50 - $55•Remote

About The Position

The LTSS Assessment RN enhances frail seniors’ ability to age in place, manage their health, navigate the health care system, and live independently. The role provides person-centered care in accordance with SCAN’s care management, disease management, and complex and enhanced care management programs. Working directly with members by telephone as an integral part of the care team, the RN develops and implements plans of care and provides health education and coaching to help members manage chronic conditions, prevent symptom exacerbation, and avoid unnecessary emergency room visits and hospital admissions. This is a temporary, telephonic remote role working Pacific Time Zone business hours. A California RN license is required.

Requirements

Associate’s degree in nursing (ASN).
Active California Registered Nurse (RN) license.
At least 3 years of experience in managed care, a healthcare environment, or case management.
Strong interpersonal skills, including excellent written and verbal communication.
Strong organizational, critical-thinking, and multitasking skills.
Ability to maintain confidentiality appropriately.
General understanding of NCQA standards and CMS and DHCS regulations.
General knowledge of medical terminology and abbreviations.
Deep understanding of local community resources for seniors.
Leadership skills, including the ability to develop others.
Problem-solving ability, including making critical decisions involving high-level risk assessment and adapting to changing circumstances.
Strategic mindset, including formulating strategies and mapping steps to achieve strategic goals.

Nice To Haves

Bachelor’s degree in nursing (BSN) strongly preferred.
Graduate or advanced degree preferred.
Bilingual English/Spanish preferred; proficiency may be assessed by a test.
At least 2 years of experience working with seniors and working remotely strongly preferred.
Curiosity about AI and its potential to transform operations and member services.

Responsibilities

Conduct 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), including determining Nursing Facility Level of Care.
Evaluate assessment findings against evidence-based guidelines, clinical reasoning, and best practices to ensure clinical appropriateness of member-centered care plans.
Use clinical insights and community standards to develop comprehensive care strategies.
Participate as needed in interdisciplinary planning and case conference meetings, supporting person-centered care and members transitioning from inpatient or institutional settings.
Build strong working relationships with the Medical Groups team.
Provide education, coaching, and disease management for chronic conditions as needed, identifying preventive interventions to avoid exacerbations or worsening conditions.
Promote member engagement and patient activation to support effective self-management and health outcomes.
Adhere to SNP Model of Care requirements and procedures.
Complete timely and accurate documentation across multiple computer systems, including assessments, care plans, service plans, authorizations, and progress notes.
Comply with regulatory and quality standards, including those of CMS, DHC, and DHCS, and adhere to applicable quality, compliance, and regulatory requirements.
Support achievement of SCAN’s vision and goals.
Perform other duties as assigned.