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SCAN

Not-for-profit Medicare Advantage plan for seniors

Nursing Supervisor - Medical Management-RN

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timeLong Beach, CA, USA

About the Job

Requirements

  • An Associate's Degree in Nursing is required; a Bachelor's Degree in Nursing is preferred.
  • An active RN license is required.
  • Two to three years of related experience and at least one year of leadership experience are required.
  • Experience with inpatient Utilization Management is required.
  • Knowledge of Medicare Advantage is required.
  • Basic skills in developing others are required.
  • Basic problem-solving skills are required.
  • Good communication and interpersonal skills are required.
  • Ability to work as part of a team is required.
  • Oral and written communication skills are required.
  • Attentiveness is required.
  • Detail-oriented work is required.

Responsibilities

  • Provide oversight and support to Medical Management clinical staff and operations, ensuring department adherence to protocols, procedures, and regulatory compliance standards.
  • Be accountable for unit operations and ensure staff perform functions in compliance with regulatory requirements, clinical standards, internal policies, procedures, and metrics.
  • Promote and adhere to regulatory and quality standards, including Centers for Medicare and Medicaid Services, Department of Managed Health Care, Department of Health Care Services, and National Committee for Quality Assurance requirements.
  • Oversee the quality of nursing activities and staff functions in assigned areas, and manage a partial caseload when needed to back up staff.
  • Ensure productivity and quality metrics align with department goals and objectives.
  • Conduct regular audits to assess competency and clinical performance, ensure quality and compliance, and monitor Interrater Reliability testing outcomes.
  • Provide coaching and education and implement corrective action measures as needed.
  • Guide and support staff on complex clinical issues and escalation needs.
  • Support department policy and procedure, desktop procedure, workflow, and training-material needs, ensuring materials are current and accurate for consistent quality care and regulatory compliance.
  • Communicate job expectations; plan, monitor, and appraise job results; coach and counsel employees; and initiate, coordinate, and enforce systems, policies, and procedures as directed.
  • Actively support the achievement of SCAN's vision and goals.
  • Perform other duties as assigned.

Desired Qualifications

  • Curiosity about AI and its potential to transform operations and member services.

About the Company

SCAN

Not-for-profit Medicare Advantage plan for seniors

SCAN provides health coverage for seniors through Medicare Advantage and offers community programs like Independence at Home and Volunteer Action for Aging. Members enroll in SCAN’s Medicare Advantage plan to receive medical benefits, and SCAN also runs in-home care and community services that support aging in place, funded by the organization and partners. It differentiates itself as a not-for-profit with a long history (since 1977) focused on seniors and caregivers and backed by strong employee benefits and community engagement. The goal is to help seniors stay healthy and independent by improving access to care and strengthening the communities the organization serves.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Long Beach, CA
Founded
1977

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