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SCAN

Not-for-profit Medicare Advantage plan for seniors

LTSS Assessment Registered Nurse

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timeRemote in USA$50 - $55 /hr

About the Job

Requirements

  • An Associate's degree in nursing is required.
  • A California Registered Nurse license is required.
  • At least 3 years of experience in managed care, a healthcare environment, or case management is required.
  • Strong interpersonal skills, including written and verbal communication skills, are required.
  • Strong organizational skills are required.
  • Strong critical thinking skills are required.
  • The ability to multitask is required.
  • The ability to maintain confidentiality appropriately is required.
  • General understanding of NCQA standards and CMS and DHCS regulations is required.
  • General knowledge of medical terminology and abbreviations is required.
  • Deep understanding of local community resources for seniors is required.

Responsibilities

  • Perform initial and annual telephonic assessments with a Community Health Worker for Medi-Cal/Medicare dually eligible members referred to Care Coordination for LTSS, and determine Nursing Facility Level of Care.
  • Evaluate assessment findings against evidence-based guidelines, clinical reasoning, and best practices to ensure clinical appropriateness of member-centered care plans, integrating clinical insights and community standards into care strategies.
  • Participate as needed in interdisciplinary planning and case conference meetings to support person-centered care and members following discharge from an inpatient or institutional setting, and build working relationships with the Medical Groups team.
  • Provide education, coaching, and disease management for chronic conditions as needed, identifying preventive interventions to avoid exacerbations or worsening conditions.
  • Promote member engagement and patient activation to support self-management and health outcomes.
  • Use organizational, decision-making, critical thinking, and multitasking skills to solve problems and achieve member outcomes; adhere to SNP Model of Care requirements and procedures; and complete timely, accurate documentation across multiple computer systems, including care plans, service plans, and progress notes.
  • Complete timely and accurate assessment documentation in multiple computer systems, including care plans, service plans, authorizations, and progress notes.
  • Comply with regulatory and quality agency standards, including CMS, DHC, and DHCS requirements.
  • Adhere to quality, compliance, and regulatory standards.
  • Support achievement of SCAN's vision and goals.
  • Perform other duties as assigned.

Desired Qualifications

  • A Bachelor's degree in nursing is strongly preferred; a graduate or advanced degree is preferred.
  • Bilingual English/Spanish proficiency is preferred and may be assessed by a test.
  • At least 2 years of experience working with seniors and working remotely is strongly preferred.

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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