Care Manager, Field - San Fernando, United States - HealthCHEC

Description

**Position is field/remote - territory is San Fernando Valley & Antelope ValleyAbout 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 JobEnhance frail seniors, ability to age in place, manage their health and live independently by conducting initial home assessments and annual home reassessments in collaboration with a Registered Nurse (RN).

Assessments will determine Nursing Facility Level of Care (NFLOC) status for MediCal/Medicare dually eligible members. Satisfies requirements for SCAN state contract for NFLOC members and CMS requirements for Special Needs Plan (SNP) membership.

You WillPerforms initial and annual home assessments for MediCal/Medicare dually eligible members referred to Care Coordination to determine eligibility for Long-Term Services and Supports (LTSS).Assists Registered Nurse in determining Nursing Facility Level of Care.

Assesses for unmet LTSS needs and develops and mails corresponding service plans. Provides short term care coordination/care management which includes coaching, education, healthcare navigation member advocacy and referrals to community-based resources.

Counsels patients to take an active role in both chronic disease and health prevention, utilizing motivational interviewing, self-management support and patient education.

Prepares Service Authorizations, arranges, coordinates, and monitors services for members per department guidelines.

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.

Evaluates and analyzes assessment information to assist RN to identify problems, goals and interventions to develop an individualized care plan based on SCAN's evidence-based clinical guidelines while exercising clinical knowledge.

Follows SNP policy and procedures and ensures all appropriate assessments for this population are completed and acted upon within established timeframes.

Maintains the member's right to privacy & protects SCAN operations by keeping information confidential.
Actively support the achievement of SCAN's Vision and Goals.
Other duties as assigned.
Your QualificationsBachelor's degree in Social Work, Gerontology, Psychology or related field. A comparable combination of education/experience and/or training will be considered equivalent to the education listed.
BILINGUAL

• Must be bilingual in English/Spanish.

(Test will be administered to assess proficiency.)3+ years managed care, healthcare environment or case management experience.
Experience working with seniors, conducting home visits and working remotely strongly preferred.
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.
NCQA standards, CMS and DHCS regulations.

Tuberculosis Screening PolicyTo 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:
$25.39 to $40.63 per hourAn annual employee bonus programRobust Wellness ProgramGenerous paid-time-off (PTO)Ten paid holidays per year, plus 1 additional floating 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 teamQualified 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-RemoteEqual 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)