Sr. Field Care Manager

5 days ago


Palm Springs CA United States Scan Health Plan Full time

About SCAN

Apply promptly A high volume of applicants is expected for the role as detailed below, do not wait to send your CV.

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 277,000 members in California, Arizona, Nevada, Texas and New Mexico. 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

Enhance frail seniors' ability to age in place, manage their health, navigate the health care system, and live independently by providing person-centered care in accordance with ECM requirements. This individual will act as an integral part of the care team by working directly with members telephonically and in their home environment to develop and implement plans of care, advocate on behalf of the member and provide member-centric interventions.

You Will

Perform initial and annual home assessments for Medi-Cal/Medicare dually eligible members referred to Care Coordination for Long-Term Services and Supports (LTSS) and assist the Registered Nurse in determining Nursing Facility Level of Care.

Support member well-being by using strong observation skills, positive communication, and motivational interviewing to coordinate care between the member and the care team. Provide ongoing face-to-face or telephonic visits with members to identify barriers with accessing care, to ensure implementation of the individualized care plan.

Assess members home environment to identify physical, social, emotional and knowledge barriers to maintain optimal member care. Identifies pertinent information and communicates to the care team.

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.

Provides short term care coordination/care management and empower members to take an active role in in chronic disease and health management, which may include coaching, education, healthcare navigation member advocacy, and referrals to community-based resources.

Assist members and caregivers in taking an active role in health management and promotion, through coaching, education, navigation and referrals to appropriate care and community-based resources.

Completes timely and accurate documentation in multiple computer systems to complete assessment and corresponding documentation: care plans, service plans, authorizations, and progress notes as necessary.

Demonstrates excellent organizational, decision-making, critical thinking, and multi-tasking skills as demonstrated by problem solving and achieving successful member outcomes. Follow all SNP policy and procedures and Complete timely and accurate documentation in multiple computer systems, including; care plans, service plans, and progress notes as necessary within established timeframes.

Demonstrates excellent organizational, decision-making, critical thinking, and multi-tasking skills as demonstrated by problem solving and achieving successful member outcomes. 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, and supports the achievement of SCAN's Vision and Goals.

All other duties as assigned.

Your Qualifications

Bachelor's Degree required in Social Work, Gerontology, Psychology, Human Services, or related field.

Bilingual - Must be bilingual in English/Spanish (Test will be administered to assess proficiency).

Travel 50% + of the time in the assigned area (Palm Springs, CA). Must have a valid driver's license, automobile insurance and reliable transportation.

3+ years managed care, healthcare environment, or case management.

2+ years working with seniors, conducting home visits and working remotely strongly preferred.

Leadership - Skilled to develops others

Problem Solving - Make critical decisions, often involving high-level risk assessment and the ability to adapt to changing circumstances

Strategic Mindset - Formulates strategy and maps steps to achieve strategic goals

Strong interpersonal skills, including excellent written and verbal communication skills.

Strong organizational skills.

Strong critical thinking skills.

Ability to multitask.

Ability to appropriately maintain confidentiality.

General understanding of NCQA standards, CMS and DHCS regulations.

General knowledge of medical terminology and abbreviations.

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.

What's in it for you?

Base salary range: $25.38 to $40.63 per hour
Internal Title - Care Manager, Sr.
Remote/Field Based Work Mode - must live in Palm Springs Territory
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

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

#LI-CS2

#LI-Remote

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)



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