Manager, Care Coordination - Long Beach, United States - SCAN

Description

About SCANSCAN 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 270,000 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 40 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 , , or follow us on LinkedIn, Facebook, and Twitter.

The JobManages the daily operations and continuous quality improvement of the Care Coordination Clinical Resource Triage Team (CRTT), Continuity of Care (COC) team, and other clinical care coordination teams to ensure the delivery of quality, coordination of care, and to drive provider and member engagement.

You WillProvides daily oversight and leadership to teams to drive operations and productivity and to ensure achievement of department goals and objectives.

Ensures that department policy and procedures, desktop procedures, workflows, and training materials, are current and accurately reflect processes in order to provide consistent quality care and assistance to members in navigating the health care system.

Continually evaluates need for process improvements, implements necessary workflow changes, and updates all relevant materials to increase effectiveness and efficiencies across all teams.

Accomplishes results by communicating to staff job expectations; planning, monitoring, and appraising job results; coaching and counseling employees; initiating, coordinating, and enforcing systems, policies, and procedures.

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.

Enhances Provider Organization (PO) performance as it relates to access to care standards and Specials Needs Plan requirements through collaboration and providing information, clarification, and support.

Acts as a subject matter expert and represents department at assigned committees to support two-way communication between department and committee and committee to department head and/or staff as appropriate.

Collaborates with department management and key stakeholders to create and review department metrics and reporting.

Builds effective professional relationships with providers and other internal and external partners utilizing verbal and written communication skills, developing trust, meeting timelines, respecting cultural differences, using active listening skills, and maintaining confidentiality.

Maintains staff by recruiting, selecting, orienting, and training employees; maintaining a safe and secure work environment; developing personal growth opportunities.

Actively supports the achievement of SCAN's vision and goals.
Supervises/Manages Others (i.e. hires, performance reviews, corrective action, etc.)- Span of Control (approximate): 7 Direct, 16 IndirectOther duties as assigned

Your QualificationsRequired:
Bachelor's degree in Nursing or related field and current and active California RN License (Graduation from an accredited school of nursing)

Preferred, if applicable:

Case Management Certification (CCM), Accredited Case Management (ACM) or Certified Professional of Utilization Management (CPUM) preferredMedicare/Medi-Cal experience in managed care environment2+ years of supervisory or management role required2+ of case management experience in a medical group, IPA and/or HMO setting preferredExperience with coordinating diverse groups of individuals to achieve success of the overall program.

Strong written and oral communication skills, as well as strong interpersonal, critical thinking, and analytical skills.
Demonstrated ability to work with all levels of staff, within and external to the organization to achieve goals.

Ability to prioritize multiple and competing tasks, work independently and in a team environment while working in a fast-paced and dynamic environment.

Medical and clinical terminology conversant.
Basic knowledge of related NCQA standards, CMS and DHCS regulations.

What's in it for you?Base salary range:
$92,400.00to $147,800.00 per yearWork Mode

• Mostly RemoteAn annual employee bonus programRobust Wellness ProgramGenerous paid time off (PTO)Ten paid holidays per year, plus 1 additional floating holiday, plus 1 birthday holidayExcellent 401(k) Retirement Saving Plan with employer match and contributionRobust employee recognition programTuition reimbursementAn opportunity to become part of a team that makes a difference to our members and our community every dayWe're always looking for talented people to join our team Qualified applicants are encouraged to apply nowAt 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-HybridEqual Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe 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 c)