Remote Care Manager (After-Hours Coverage)

SHPCA SCAN Health Plan; California (MO); Hybrid; USD 46,838 - 75,768; Full time

Benefits offered by this job

Remote work

Annual bonus

Wellness program

Generous PTO

11 paid holidays

401(k) with employer match

Tuition reimbursement

Job summary

SCAN Health Plan is seeking a Care Manager to coordinate member care across the Integrated Care Team in a fully remote capacity. The role emphasizes utilization management, medical necessity reviews, and timely service delivery to ensure appropriate levels of care and smooth transitions between settings.

The candidate should have an Associate's degree or equivalent experience with CA LVN license, plus 3–5 years of related experience.

Qualifications

• Problem solving and analytical thinking are required.
• Excellent communication with patients, families and providers.
• Customer-focused approach to care coordination.
• Attention to detail and organizational skills are essential.
• Responsible and reliable with the ability to handle complex cases.

Responsibilities

• Coordinate care for SCAN members with the Integrated Care Team.
• Authorize services based on utilization management and medical necessity.
• Review pre-service and concurrent care following guidelines.
• Discharge planning and coordination across settings (inpatient, SNF, home).
• Provide clinical guidance to Care Coordinators and speak with patients and families.
• Ensure timely service delivery and adherence to policies and regulations.

Skills

Problem-Solving

Strong Communication

Customer focused

Detail oriented

Responsible

Education

Associate's Degree or equivalent experience

CA LVN license

Job description

SCAN Health Plan is seeking a Care Manager to coordinate member care across the Integrated Care Team in a fully remote capacity. The role emphasizes utilization management, medical necessity reviews, and timely service delivery to ensure appropriate levels of care and smooth transitions between settings.

The candidate should have an Associate's degree or equivalent experience with CA LVN license, plus 3–5 years of related experience.