Supervisor RN, Care Management

SHPCA SCAN Health Plan•Long Beach, CA

1d•Remote

About The Position

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 300,000 members in California, Arizona, Nevada, Texas, New Mexico & Washington. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 45 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org , www.scanhealthplan.com , or follow us on LinkedIn, Facebook, and Twitter. The Job Contributes to the care and well-being of SCAN's most complex members, empowering members to age in place by overseeing the day-to-day operations and outcomes of a multidisciplinary care management team. Defines daily priorities for telephonic and field staff and responsible for team compliance with all regulatory requirements, clinical standards and internal policies and procedures so staff can focus on addressing members’ care management needs, supporting navigation of the healthcare system, and responding to and resolving escalated issues with compassion and efficiency. Implements and oversees chronic disease management programs.

Requirements

BILINGUAL preferred in English/Spanish. (Test will be administered to assess proficiency if applicable.)
Bachelor’s Degree in Nursing (BSN) required.
CA Registered Nurse (RN) License required
2 to 4 years working in managed care, healthcare environment, or case management.
Leadership- Basic skills to develops others
Problem Solving - Basic problem-solving skills
Communication - Good communication and interpersonal skills
Strong interpersonal skills, including excellent written and verbal communication skills.
Strong organizational skills.
Strong critical thinking skills.
Ability to collaborate effectively within a multidisciplinary team, both within SCAN and with provider partners.
Ability to appropriately maintain confidentiality.
Strong knowledge of medical terminology and abbreviations.
Deep understanding of CMS and DHCS regulations, including Special Needs Plan requirements.
Deep understanding of local community resources for seniors.
Tuberculosis Screening Policy To ensure the health and safety of our members, if you are selected for this position, your job offer with SCAN will be contingent on providing proof of Tuberculosis screening upon hire or providing proof of a negative screening within the last year. If you have a disability/medical reason or sincerely held religious belief that prevents you to provide information required in this policy, SCAN will initiate and engage in the interactive process to evaluate what, if any, reasonable accommodations may be available.

Nice To Haves

Graduate or Advanced Degree or equivalent experience preferred, such as MSN, DNP, etc.
2+ years working with seniors and working remotely strongly preferred.

Responsibilities

Supervises the day-to-day operations, productivity, and quality of a multidisciplinary team to ensure alignment with and achievement of department goals and objectives.
Monitors performance and compliance with regulatory requirements, clinical standards, and internal policies and procedures through frequent oversight of reports and auditing. This includes awareness of scope of practice and licensure requirements for functions overseen.
Provides team with ongoing performance updates and support through regular one-on-one meetings and ad hoc consultations.
Acts as subject matter expert for team, members, providers, internal and external departments for interpretation and administration of various benefits/programs, and to troubleshoot a wide range of extremely complex psychosocial and escalated access issues for dually enrolled Medicare/Medi-Cal SCAN beneficiaries and other SCAN members.
Ensures that department policy and procedures, desktop procedures, workflows, job aides, training materials, are current and accurately reflect processes to provide consistent quality care and meet compliance with regulatory requirements.
Demonstrates high level organizational, analytical, critical thinking, and leadership skills to resolve issues and assist team members with members, providers, vendors, and other internal and external departments.
Facilitates team meetings, keeps accurate documentation, and leads special projects with an ability to balance competing priorities.
Uses advanced motivational interviewing techniques to understand and accurately address member concerns, and to de-escalate when needed to minimize conflict and avoid grievances from members and providers.
Exhibits professionalism and empathy in all interactions and able to de-escalate tense situations with staff, members, provider partners, and other departments.
Provides staff coaching and education to both telephonic and field-based staff.
Develop and implement leadership development plans for staff with growth potential.
Develop performance improvement plans and implement corrective action measures as needed.
Maintains skill in software applications that are integral to the job functions and assumes role of primary trainer. Also, make recommendations on technology improvement opportunities to streamline workflows and processes.
Adhere to all quality, compliance, and regulatory standards.
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.

Benefits

Base salary range: $106,200 to $153,705 per year
Remote position - Southern California travel with staff in LA, OC, SD & Inland Empire approximately 25%
An annual employee bonus program
Robust Wellness Program
Generous paid-time-off (PTO)
Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
Excellent 401(k) Retirement Saving 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!