RN, Care Management

SHPCA SCAN Health Plan; California (MO); Hybrid; USD 92,000 - 127,000; Full time

Benefits offered by this job

Annual bonus program

Wellness program

Generous PTO

11 paid holidays + birthday holiday

Job summary

SCAN Health Plan seeks an experienced Registered Nurse to enhance members’ ability to age in place through person-centered care management and disease management programs. The role emphasizes telephonic assessments, care coordination, and education while maintaining compliance with CMS and NCQA standards.

You will work with a multidisciplinary team to develop and implement care plans, support LTSS referrals, and ensure accurate documentation in multiple systems. Remote work is predominant.

Qualifications

• ASN required; RN license mandatory.
• BSN preferred; graduate degree preferred.
• 3+ years in managed care or healthcare.
• 2+ years working with seniors; remote work preferred.
• Bilingual English/Spanish preferred.

Responsibilities

• Coordinate care plans for Medicare/Medicaid members by phone.
• Conduct initial and annual telephonic assessments with LTSS referrals.
• Support CICM activities for POF groups.
• Ensure adherence to CMS, DHCS, NCQA standards.
• Document care plans and progress notes on time.

Skills

Bilingual English/Spanish

Clinical Nursing

Care Coordination

Telephonic Assessment

Patient Education

Education

ASN

RN license

BSN preferred

Graduate degree preferred

Job description

About the Organization

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 Summary

*CA RN Required. Position will work Pacific Time Business Hours*

This role enhances 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.

• Act as an integral part of the care team by working directly with members telephonically to develop and implement plans of care, provide health education and coaching to manage chronic conditions and prevent exacerbation of symptoms and prevent avoidable ER visits and hospital admissions.
• 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 Long-Term Services and Supports (LTSS) and in determining Nursing Facility Level of Care.
• Perform nursing related California Integrated Care Management (CICM) 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.
• Ensure the clinical appropriateness of member-centered care plans based on assessment against evidence-based guidelines, clinical reasoning, and best practices.
• Integrate clinical insights and community standards to develop comprehensive and effective care strategies.
• Actively collaborate 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.
• Build strong working relationships with the Medical Groups team.
• Provide education, coaching, and disease management for chronic conditions by identifying new and preventable interventions to avoid exacerbations or worsening conditions.
• Promote member engagement and patient activation to ensure optimal self-management for successful health outcomes.
• Demonstrate organizational, decision-making, critical thinking, and multi-tasking skills as demonstrated by problem solving and achieving successful member 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.
• Comply with all regulatory and quality agency standards including Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DHC), and Department of Health Care Services (DHCS).
• Actively support the achievement of SCAN's Vision and Goals.
• Other duties as assigned.

Qualifications

• Associate's degree in nursing (ASN) required.
• Bachelor's degree in nursing (BSN) preferred.
• Graduate or Advanced Degree preferred.
• CA Registered Nurse (RN) required.
• Strongly Preferred: BILINGUAL English/Spanish. (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 goal.
• 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.

Compensation and Benefits

Base salary range: $44.42 to $61.20 per hour

Work Mode: Mostly Remote. Employees who reside outside the local area are expected to work remotely and travel to SCAN's headquarters approximately once per month for in-person meetings, team collaboration, training, and other business needs. SCAN's headquarters is currently located in Long Beach, California, and is expected to relocate to Cerritos, California, in 2027.

• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
• Excellent 401(k) Retirement Saving Plan with employer match and contribution
• Robust employee recognition program
• Tuition reimbursement
• Opportunity to become part of a team that makes a difference to our members and our community every day!

Equal Opportunity

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affflstive Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law.

A background check is required.

#LI-CS2 Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

Pay Transparency Policy

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

Why Consider a Career at SCAN?

• A competitive compensation and benefits program;
• An annual employee bonus program;
• Generous paid-time-off (PTO);
• Eleven paid holidays per year;
• Excellent Retirement Savings program;
• A work-life balance;
• An opportunity to become part of a team that makes a difference to our members and our community every day!