Social Worker, Care Management

SCAN Health Insurance•Los Angeles, CA

1d•$39 - $53•Remote

About The Position

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve. This is a mostly remote role with work hours M-F 8am - 5pm Pacific Time The Job Support high risk members by providing person-centered interventions to support serious mental illness, substance use disorder, and behavioral barriers to care. Collaborate with the care team to assess, develop, and implement care plans while addressing health, behavior, and psychosocial needs through telephonic, virtual, or in-person visits. Focus on holistic support to enhance independence and prevent unnecessary healthcare events, including ER visits and hospital admissions.

Requirements

Graduate or Advanced Degree required in Social Work.
3-5 years managed care, healthcare environment, or mental health case management.
2 + years working with seniors and working remotely strongly preferred.
Technical expertise - Advanced analytical skills
Problem Solving - Basic problem-solving skills
Communication - Good communication and interpersonal skills
Bilingual Spanish/English strongly preferred. A test will be administered to assess proficiency if applicable.
Strong interpersonal skills, including excellent written and verbal communication skills.
Strong organizational skills.
Strong critical thinking skills.
Ability to collaborate effectively with a multidisciplinary team.
Ability to appropriately maintain confidentiality.
Ability to communicate complex medical information with simplicity and kindness and build strong rapport.
General understanding of NCQA standards, CMS and DHCS regulations
Tuberculosis Screening Policy

Nice To Haves

Licensed Clinical Social Worker preferred; CCM preferred.

Responsibilities

Conduct comprehensive assessments to identify chronic conditions and psychosocial challenges affecting independent living, prevent utilization and support member’s overall goals of care.
Manage and provide targeted support for members with serious mental illness, substance use disorder, and behavioral barriers to care, including those identified as high-risk, ensuring comprehensive care and appropriate interventions.
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.
Provide education and coaching surrounding behavioral and mental health treatment, interventions, and pharmacological approaches. Work with members in the prevention of illness, promotion of health, and management of member’s adjustment to chronic health problems.
Strong collaboration with internal and external providers, specifically with BH/MH vendors and programs. Serve as the key point of contact for complex behavioral health cases to assist with care coordination and act as Subject Matter Expert (SME)
Exhibit comprehensive member engagement and patient activation skills with the ability to communicate complex medical and behavioral health interventions cohesively with overall plan of care.
Perform Enhanced Care Management (ECM) activities related to 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.
Actively participates in interdisciplinary planning and case conference meetings to ensure person centered care and to ensure member receives support following discharge from an inpatient or institutional setting. Build strong working relationships with the Medical Groups, vendors, and community organizations.
Utilizes department desktop procedures, workflows, job aids and training material. Identifies barriers to work processes and brings to the attention of the supervisor/manager.
Actively Adheres to all quality, compliance, and regulatory standards.
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.