Care Manager – LVN

🕒 Junho 11

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $34 - $55 / hora

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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SCAN

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 1977

⚕️ Seguro de Saúde

👥 B2C

Healthcare Insurance • B2C

A SCAN é uma organização de saúde orientada por uma missão, focada em reinventar o envelhecimento ao fornecer cuidado e cobertura centrados no paciente e baseados em evidências para idosos. Ela opera um portfólio integrado que inclui planos de seguro de saúde com benefícios inovadores, atendimento primário domiciliar e virtual, programas de apoio para cuidadores e idosos confinados em casa, além de serviços especializados para populações vulneráveis. A SCAN também investe e faz parcerias com empresas que avançam nos modelos de cuidado e recursos para ajudar os idosos a se manterem saudáveis e independentes em casa.

Descrição

• Serve as point person to speak with patients, family members, and providers to address concerns pertaining to care, transfers and authorizations • Ensure necessary inpatient and outpatient care or other services are rendered to SCAN members at the right time, the right level of care and at the right location, with end-to-end coordination, while adhering to all policies and procedures • Coordinate discharge needs from inpatient acute settings and skilled nursing facilities as appropriate for each member • Coordinate timely delivery of last cover day letters to skilled nursing facilities • Issue determinations within required regulatory timeframes • Apply evidenced-based criteria and guidelines, as well as clinical judgment and expertise, to help develop treatment plans • Review tasks assigned by Integrated Care Nurse Practitioners and coordinate member care accordingly • Review all acute/skilled nursing appeals and create detail explanation of non-coverage and reinstatement letters • Prepare, participate and facilitate high risk huddles and/or skilled nursing rounds • Maintain a list of high risk patients and conduct regular outreach calls to check on their health status • Develop effective working relationships and collaboration with Care Coordinators on clinical matters • Demonstrate excellent organizational, decision-making and multi-tasking skills as demonstrated by problem-solving and successful outcomes • Promote the mission, vision, and values of SCAN Health Plan and serve as an ambassador when interfacing and collaborating with external stakeholders

🎯 Requisitos

• Associate's Degree or equivalent experience • 3-5 years of related experience • CA LVN license • Performs work under direct supervision • Handles basic issues and problems, and refers more complex issues to higher-level staff • Possesses beginning to working knowledge of subject matter • Provides leadership, coaching, and/or mentoring to partner care coordinators

🏖️ Benefícios

• Annual bonus program • Robust Wellness Program • Generous paid-time-off (PTO) • Eleven paid holidays per year • One additional floating holiday • One birthday holiday • Excellent 401(k) Retirement Saving Plan with employer match and contribution • Robust employee recognition program • Tuition reimbursement