Remote LTSS Assessment RN Part Time

SHPCA SCAN Health Plan; California (MO); Hybrid; USD 143,270,000 - 157,597,000; Part time

Benefits offered by this job

Remote work

Medical Benefits

Paid Sick Time

401(k) Retirement Plan

Employee recognition program

Mission-driven team

Job summary

SCAN Health Plan is seeking a part-time, telephonic RN to support frail seniors, primarily in a remote capacity during Pacific Time business hours. You will conduct assessments, verify care plans, and coordinate with LTSS and care management programs to promote independent living for Medi-Cal/Medicare members.

The role requires CA RN licensure, ADN/BSN, and 3+ years in managed care or case management, with bilingual English/Spanish preferred.

Qualifications

• Associate's degree in nursing (ADN/ASN) required.
• Bachelor's degree in nursing (BSN) strongly preferred.
• Graduate or Advanced Degree preferred.
• CA Registered Nurse (RN) required.
• BILINGUAL English/Spanish preferred. (Test will be administered to assess proficiency if applicable.)
• 3+ years managed care, healthcare environment, or case management.
• 2+ years working with seniors and working remotely strongly preferred.
• Leadership - Skilled to develops others
• Problem Solving - Make critical decisions, often involving high-level risk assessment and the ability to adapt to changing circumstances
• Strategic Mindset - Formulates strategy and maps steps to achieve strategic goals
• 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.
• General understanding of NCQA standards, CMS and DHCS regulations.
• General knowledge of medical terminology and abbreviations.
• Deep understanding of local community resources for seniors.

Responsibilities

• 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 care management, disease management, and complex and enhanced care management programs at SCAN.
• Perform initial and annual telephonic assessments in conjunction with a Community Health Worker for Medi-Cal/Medicare dually eligible members referred to Care Coordination for LTSS and in determining Nursing Facility Level of Care.
• Ensure the clinical appropriateness of member-centered care plans by evaluating assessment findings against evidence-based guidelines, clinical reasoning, and best practices.
• Promote member engagement and patient activation to ensure optimal self-management for successful health outcomes
• Adhere to all SNP Model of Care requirements and procedures.
• Complete timely and accurate documentation across multiple computer systems, including care plans, service plans, and progress notes as necessary within established timeframes.
• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

Skills

Bilingual English/Spanish

Strong communication

Leadership

Problem solving

Strategic mindset

Multitasking

Confidentiality

Critical thinking

Education

Associate's degree in nursing

Bachelor's degree in nursing

CA RN license

Graduate/Advanced degree

Job description

SCAN Health Plan is seeking a part-time, telephonic RN to support frail seniors, primarily in a remote capacity during Pacific Time business hours. You will conduct assessments, verify care plans, and coordinate with LTSS and care management programs to promote independent living for Medi-Cal/Medicare members.

The role requires CA RN licensure, ADN/BSN, and 3+ years in managed care or case management, with bilingual English/Spanish preferred.