Care Manager – LVN

🔥 12 hours ago

🇺🇸 United States – Remote

💵 $34 - $55 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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SCAN

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1977

⚕️ Healthcare Insurance

👥 B2C

Healthcare Insurance • B2C

SCAN is a mission-driven healthcare organization focused on reinventing aging by delivering evidence-based, patient-centered care and coverage for older adults. It operates an integrated portfolio including health insurance plans with innovative benefits, in-home and virtual primary care, support programs for caregivers and homebound older adults, and specialized services for vulnerable populations. SCAN also invests in and partners with companies that advance care models and resources to help older adults remain healthy and independent at home.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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