Remote RN Leader, Medical Management & Compliance

SCAN Health Plan; Long Beach (CA); Remote; USD 92,000 - 134,000; Full time

Benefits offered by this job

Annual bonus program

Wellness program

PTO

11 paid holidays + floating holiday +

401(k) with employer match

Recognition program

Tuition reimbursement

Job summary

SCAN Health Plan is seeking a Nursing leader to oversee Medical Management clinical staff and ensure adherence to protocol and regulatory standards. You will assess performance, develop education plans and drive improvement initiatives.

The role offers remote work with periodic travel to SCAN's Long Beach/CA headquarters, a competitive base pay, annual bonus program, and comprehensive benefits.

Qualifications

• Must have an Associate's Degree in Nursing.
• RN license is required.
• 2-3 years of related experience; 1+ year of leadership.
• Experience with inpatient Utilization Management required.
• Medicare Advantage knowledge required.
• Leadership skills to develop others.

Responsibilities

• Oversee unit operations to ensure regulatory compliance and adherence to policies.
• Provide oversight of nursing activities and back-up support as needed.
• Ensure productivity and quality metrics align with department goals.
• Conduct regular audits to ensure quality and compliance; provide coaching.
• Support staff around complex clinical issues and escalation.

Skills

Utilization Management

Medicare Advantage

Leadership

Problem Solving

Communication

Teamwork

Oral & Written Communication

Detail oriented

Education

Associate's Degree in Nursing

RN license

Job description

SCAN Health Plan is seeking a Nursing leader to oversee Medical Management clinical staff and ensure adherence to protocol and regulatory standards. You will assess performance, develop education plans and drive improvement initiatives.

The role offers remote work with periodic travel to SCAN's Long Beach/CA headquarters, a competitive base pay, annual bonus program, and comprehensive benefits.