Remote Care Coordination Manager

SCAN Health Insurance; City of Long Beach (NY); On-site; USD 92,000 - 127,000; Full time

Benefits offered by this job

Annual bonus program

Wellness program

Paid time off (PTO)

11 holidays + floating + birthday

401(k) with employer match

Tuition reimbursement

Job summary

SCAN Health Insurance seeks a Manager, Care Coordination to lead teams delivering education and navigation assistance for members, ensuring compliance with regulatory requirements and best practices. You will oversee staffing, workflows, and program policies, while driving performance and quality across the department.

The role requires 5+ years in healthcare leadership, NCQA/CMS knowledge, and strong communication skills. Mostly remote work with a comprehensive benefits package is offered.

Qualifications

• Bachelor’s Degree or equivalent experience.
• 5+ years of experience in healthcare, medical management, change management, and/or leadership.
• Demonstrated management experience.
• Must possess working knowledge of NCQA standards, SNP requirements, and CMS and DHS regulations.
• Knowledge and/or familiarity with the principles of project and program management.
• Able to lead and influence those without direct reporting relationships to achieve desired outcomes.
• Ability to communicate with clarity, the vision, value, and tasks to formal and informal audiences.
• Strong interpersonal skills, including excellent written and verbal communication skills.
• Strong organizational skills; Ability to multitask and to appropriately maintain confidentiality.
• Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams) and Visio at advanced level.

Responsibilities

• Manages teams through oversight of day-to-day operations and productivity to ensure alignment with and achievement of department goals and objectives.
• Manages workflow and assigns priorities and projects to ensure completion of required activities within the designated timeframes.
• Maintains staff by recruiting, selecting, orienting, and training employees; maintaining a safe and secure work environment; developing personal growth opportunities.
• Accomplishes staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and disciplining employees; initiating, coordinating, and enforcing systems, policies, and procedures.
• Assures HCS Policy and Procedures, desktop procedures, training materials, and program communications are current and accurately reflect the processes and regulatory requirements of the Care Coordination Department.
• Facilitates meetings, trains staff to deliver care coordination following SCAN and department policy and procedures to achieve organizational goals and outcomes.
• Acts as department subject matter expert by representing department at assigned committees to support two-way communication between departments and committees as appropriate. And provide clinical and non-clinical support to supervisors and staff for escalated issues and concerns.
• Partners with stakeholders and department management, to create and review department metric reporting for productivity and efficacy to support organizational vision and goals. Participates in the development and analysis of monthly metrics reporting.
• Assists Director in preparation of annual program evaluation, projects, and other activities as requested by management.
• Promotes compliance with and adheres to all regulatory and quality standards including but not limited to: CMS, DMHC, DHCS, NCQA as it relates to Care Coordination activities.
• 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.

Skills

Strong communication skills

Demonstrated management experience

Project management knowledge

Microsoft Office advanced

Visio

Education

Bachelor’s Degree or equivalent experience

Tools

Visio

Job description

SCAN Health Insurance seeks a Manager, Care Coordination to lead teams delivering education and navigation assistance for members, ensuring compliance with regulatory requirements and best practices. You will oversee staffing, workflows, and program policies, while driving performance and quality across the department.

The role requires 5+ years in healthcare leadership, NCQA/CMS knowledge, and strong communication skills. Mostly remote work with a comprehensive benefits package is offered.