*This is a remote role that will work Pacific Time Zone business hours*The JobContributes 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.
You WillSupervises 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.
Supervises/Manages Others (i.e. hires, performance reviews, corrective action, etc.)
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.
Your QualificationsRequired: Bachelor's Degree or equivalent experience.
Preferred: Graduate or Advanced Degree or equivalent experience.
2+ years experience working in managed care, healthcare environment, or case management.
2+ years working with seniors and working remotely strongly preferred.
Spanish speakers preferred
Leadership - Basic skills to develop others
Problem Solving - Basic problem-solving skills
Communication - Good communication and interpersonal skills
Bilingual ability strongly preferred.
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.
What's in it for you?- Base salary range: $80,300 to $130,000 per year
- Work Mode - Mostly Remote: Employees who reside outside the local area are expected to work remotely and travel to SCAN's headquarters approximately once per month for in-person meetings, team collaboration, training, and other business needs. SCAN's headquarters is currently located in Long Beach, California, and is expected to relocate to Cerritos, California, in 2027.
- 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!
We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!
