Supervisor, Medical Management-RN

SCAN Health Insurance; Long Beach (CA); À distance; USD 92 000 - 134 000; Plein temps

Avantages offerts par ce poste

Annual bonus

Wellness program

PTO

Holidays and paid time off

401(k) with employer match

Tuition reimbursement

Résumé du poste

SCAN Health Insurance seeks a Registered Nurse leader to oversee Medical Management operations, ensuring adherence to clinical standards and regulatory requirements. You will assess staff performance, develop education and improvement plans, and drive quality metrics across the department.

The role emphasizes coaching, compliance audits, and collaborative problem solving within a mostly remote work model, with periodic on-site engagement at SCAN's Long Beach headquarters.

Qualifications

• RN license required.
• Associate’s Degree in Nursing required.
• 2-3 years of related experience; leadership experience preferred.
• Medicare Advantage knowledge required.

Responsabilités

• Provide oversight of unit operations to ensure regulatory and internal policy compliance.
• Evaluate clinical staff performance and develop education and performance improvement plans.
• Ensure productivity and quality metrics align with department goals.
• Conduct audits to ensure quality and compliance; monitor interrater reliability outcomes; provide coaching and corrective action.

Connaissances

Leadership

Problem solving

Communication

Teamwork

Oral and written

Detail oriented

Formation

Associate’s Degree in Nursing

RN license

Bachelor’s Degree preferred

Description du poste

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 affirmative 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.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

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)