Supervisor, Medical Management-RN

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

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.

The Job Provide oversight and support to Medical Management clinical staff, operations, and department adherence to protocol and procedures, regulatory compliance standards. Perform assessment of clinical staff performance, develop education and performance improvement plans. You Will Responsible and accountable for unit operations to ensure staff perform functions compliant with all regulatory requirements, clinical standards and internal policies, procedures and metrics Promote compliance with and adhere to all regulatory and quality standards including but not limited to: Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), and accreditation bodies such as the National Committee for Quality Assurance (NCQA) Provide oversight to the overall quality of nursing activities and staff functions in their respective areas of responsibility May manage a partial caseload to provide back up support to staff Ensure productivity and quality metrics are aligned with department goals and objectives Ensure competency and clinical performance by conducting regular audits to ensure quality and compliance and monitoring outcomes of Interrater Reliability testing Provide coaching and education Implement corrective action measures as needed Provide guidance and support to staff around complex clinical issues and the need for escalation Support the department needs around policy and procedures, desktop procedures, workflows and training materials. Ensure all material is current and accurate to provide consistent quality care and meet compliance with regulatory requirements Communicate with staff on job expectations; planning, monitoring, and appraising job results; coaching and counseling employees; initiating, coordinating, and enforcing systems, polices, and procedures as directed.

We seek Rebels who are curious about AI and its power to transform how we operate and serve our members. Actively support the achievement of SCAN’s Vision and Goals. Other duties as assigned.

Your Qualifications Associate's Degree in Nursing. Bachelor's Degree preferred. RN license required 2-3 years of related experience - Knowledge of the field's policies, procedures, and practices. Leads and directs the work of other employees. 1+ years of leadership experience Experience with inpatient Utilization Management required Medicare Advantage knowledge required Leadership - Basic skills to develops others Problem Solving - Basic problem solving skills Communication - Good communication and interpersonal skills Ability to work as part of a team Oral and written communication skills Problem-solving skills Attentiveness Interpersonal skills Detail oriented.

What's in it for you?

• Base Pay Range: $92,400 - $133,671 per year
• 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)
• 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
• Excellent 401(k) Retirement Saving Plan with employer match
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!

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... 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. 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).

Become part of a mission-driven team that makes a difference in the lives of seniors every day.

SCAN has a long history of finding and investing in ways to meet seniors' needs. This focus is what attracts employees to SCAN. For each and every one of us, the SCAN mission is personal. Keeping Seniors Healthy and Independent is both our mission and our passion. That same commitment carries over to our employees. We provide the training, tools and support necessary to do your work. We reward effort and celebrate success. SCAN both develops and attracts people who are leading experts in their respective fields. If the SCAN mission is one you believe in too, we invite you to explore the career opportunities at SCAN.

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; and
• An opportunity to become part of a team that makes a difference to our members and our community every day!