Manager, Care Coordination

SCAN Health Insurance•Long Beach, CA

1d•$92,400 - $127,306•Remote

About The Position

The Manager, Care Coordination enhances members’ ability to manage their health and live independently by managing teams that provide education and assistance with navigating the healthcare system and managing their health, developing and monitoring processes to ensure compliance with regulatory requirements and best practices. We seek Rebels who are curious about AI and its power to transform how we operate and serve our members. Actively support the achievement of SCAN’s Vision and Goals. Other duties as assigned.

Requirements

Bachelor's Degree or equivalent experience
5+ years of experience in healthcare, medical management, change management, and/or leadership.
Demonstrated management experience.
Must possess working knowledge of related NCQA standards, SNP requirements, and CMS and DHS regulations.
Knowledge and/or familiarity with the principles of project and program management.
Demonstrated ability to develop and implement new, replacement systems, and gain buy-in from appropriate audience.
Able to lead and influence those without direct reporting relationships to achieve desired outcomes.
Ability to communicate with clarity, the vision, value, and tasks to formal and informal audiences.
Able to develop relationships quickly and leverage working relationships to drive performance outcomes.
Ability to work with all levels of staff, within and external to the organization to achieve goals.
Strong interpersonal skills, including excellent written and verbal communication skills.
Strong organizational skills; Ability to multitask and to appropriately maintain confidentiality.
Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams) and Visio at advanced level.

Responsibilities

Manages teams through oversight of day-to-day operations and productivity to ensure alignment with and achievement of department goals and objectives.
Manages workflow and assigns priorities and projects to ensure completion of required activities within the designated timeframes.
Maintains staff by recruiting, selecting, orienting, and training employees; maintaining a safe and secure work environment; developing personal growth opportunities.
Accomplishes staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and disciplining employees; initiating, coordinating, and enforcing systems, policies, and procedures.
Assures HCS Policy and Procedures, desktop procedures, training materials, and program communications are current and accurately reflect the processes and regulatory requirements of the Care Coordination Department.
Facilitates meetings, trains staff to deliver care coordination following SCAN and department policy and procedures to achieve organizational goals and outcomes.
Acts as department subject matter expert by representing department at assigned committees to support two-way communication between departments and committees as appropriate. And provide clinical and non-clinical support to supervisors and staff for escalated issues and concerns.
Partners with stakeholders and department management, to create and review department metric reporting for productivity and efficacy to support organizational vision and goals. Participates in the development and analysis of monthly metrics reporting.
Assists Director in preparation of annual program evaluation, projects, and other activities as requested by management.
Promotes compliance with and adheres to all regulatory and quality standards including but not limited to: Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), and accreditation bodies’ standards such as the National Committee for Quality Assurance (NCQA) as it relates to Care Coordination activities.