Bilingual Spanish Community Health Worker (Oceanside)

SCAN; Oceanside (CA); Hybride; USD 75 000 - 105 000; Plein temps

Résumé du poste

SCAN is a nonprofit health organization expanding care for older adults across multiple states. The role focuses on telephonic and in-person care management, coordinating services, and advocating for members to improve health outcomes and independence.

You will work on Enhanced Care Management activities for prioritized populations, develop personalized care plans, and collaborate with care teams to ensure seamless transition after discharge and ongoing support in the community.

Qualifications

• Experience with Medi-Cal/Medicare dual-eligible members
• Ability to conduct assessments and coordinate care
• Strong communication and documentation skills

Responsabilités

• Collaborate in assessments to identify chronic conditions and psychosocial challenges
• Provide person-centered care through telephonic and in-person visits to implement plans of care
• Coordinate general care and empower members and families to manage chronic conditions
• Perform Enhanced Care Management activities for targeted populations
• Develop personalized care plans addressing medical and social needs
• Participate in interdisciplinary planning and case conferences to ensure continuity of care

Description du poste

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.

Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.

Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.

At SCAN, we believe scale should strengthen—not dilute—our mission.

We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.

• Position will work remote & in the field about 75% of the time in Oceanside, CA & the surrounding areas*

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-person to implement plans of care, advocate on behalf of the member and provide member-centric interventions.

You Will

• Collaborate in conducting general assessments to identify chronic conditions and psychosocial challenges affecting independent living. Perform assessments for Medi-Cal/Medicare dual-eligible members referred to Complex Care Management for Long-Term Services and Supports (LTSS) and assist the Registered Nurse in determining Nursing Facility Level of Care.
• Support member well-being through observation, positive communication, and motivational interviewing. Conduct face-to-face or phone visits to address care barriers, ensure engagement in primary and preventative care, and support individualized care plan implementation.
• Provides general care coordination and empower members and their families in managing chronic conditions through coaching, education, healthcare navigation, advocacy, accompaniment to appointments and referrals to community, county, and state resources.
• 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.
• Implement personalized care plans tailored to the medical and social needs of high-risk members, incorporating realistic health goals supporting members inherent wishes.
• Actively participates in interdisciplinary planning and case conference meetings to ensure person-centered care and to ensure member receives support following discharge from an inpatient or institutional setting.
• Demonstrates strong organizational, follow-through, and engagement skills to achieve positive member outcomes. Adheres to SNP policies and ensures timely, accurate documentation of