RN Medical Management Lead — Remote

SHPCA SCAN Health Plan; California (MO); Hybrid; USD 92,000 - 134,000; Full time

Benefits offered by this job

Mostly Remote

Annual bonus

PTO

11 holidays per year

401(k) match

Job summary

SCAN Health Plan seeks a talented Nursing Manager to oversee Medical Management staff, ensuring adherence to CMS, DMHC, and NCQA standards. The role includes coaching, education, and performance improvement initiatives across nursing teams.

Ideal candidates hold an RN license with an Associate’s Degree in Nursing; a Bachelor’s degree is preferred. 2–3 years in related roles and leadership experience are expected, with Medicare Advantage knowledge advantageous.

Qualifications

• RN license required; Associate’s Degree in Nursing.
• 1+ year of leadership experience; Inpatient Utilization Management knowledge.
• Medicare Advantage knowledge preferred; nursing policy familiarity.

Responsibilities

• Oversee clinical staff performance and compliance with regulatory standards.
• Develop education and performance improvement plans for nursing staff.
• Ensure productivity and quality metrics align with department goals and regulatory requirements.

Skills

Leadership

Communication

Teamwork

Problem Solving

Attention to detail

Education

Associate's Degree in Nursing

Bachelor's Degree preferred

Job description

SCAN Health Plan seeks a talented Nursing Manager to oversee Medical Management staff, ensuring adherence to CMS, DMHC, and NCQA standards. The role includes coaching, education, and performance improvement initiatives across nursing teams.

Ideal candidates hold an RN license with an Associate’s Degree in Nursing; a Bachelor’s degree is preferred. 2–3 years in related roles and leadership experience are expected, with Medicare Advantage knowledge advantageous.