Care Manager – LVN

🔥 0 minutes 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 • Discharge needs may include: durable medical equipment, home health services, specialist referrals, skilled nursing placement, transportation, and other needs • 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, including services such as: home health; DME ordering, wound care, Foley catheter, Enteral, colostomy supplies, infusion orders and outpatient services • Review all acute/skilled nursing appeals and create detail explanation of non-coverage and reinstatement letters • Refer cases that do not meet established criteria to the Medical Directors for secondary review • 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 and provide clinical guidance to 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, including contracted medical groups and vendors. • Other duties as assigned. Active support of SCAN’s Vision and Goals.

🎯 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

• Base salary range: $34.47 to $55.14 per hour • Annual bonus program • Robust Wellness Program • Generous paid-time-off (PTO) • Eleven paid holidays per year, plus 1 additional floating holiday, plus 1 birthday holiday • Excellent 401(k) Retirement Saving Plan with employer match and contribution • 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!