Welcome to NASW Joblink - The Social Work Career Center
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Telecommute within San Bernardino County; Apple Valley, Hesperia, Adelanto, and Victorville.
Enhance seniors' ability to manage their health and live independently by conducting initial home assessments and annual home reassessments to determine Nursing Facility Level of Care (NFLOC) status for Medi-Medi members, in conjunction with an RN. Satisfies requirements for SCAN state contract for NFLOC members and CMS requirements for Special Needs Plan (SNP) membership.
Perform initial and annual home assessments for Medi-Medi members referred to Care Coordination determine eligibility for Long Term Services and Supports (LTSS).
Assist Registered Nurse in determining Nursing Facility Level of Care, assess for unmet home and community service needs, as well as needs for complex case management referrals.
Provide short term care coordination/case management which includes coaching, education, navigation and referrals to community based resources.
Partner with team members to prepare Service Authorizations, arrange, coordinate, and monitor service for members per department guidelines.
Complete timely and accurate documentation in multiple computer systems to complete assessment and corresponding documentation: care plans, service plans, authorizations, and progress notes as necessary.
Follow SNP policy and procedures and ensures all appropriate assessments for this population are completed and acted upon within established timeframes.
Maintain the member‘s right to privacy and protects SCAN operations by keeping information confidential.
Adhere to all quality, compliance and regulatory standards to achieve HCS and SCAN outcomes.
Actively supports the achievement of SCAN’s Vision and Goals.
Maintains professional and technical knowledge by attending educational workshops; reviewing and contributing to professional publications; establishing personal networks; participating in professional societies.
Contributes to team effort by accomplishing related results as needed.
Bachelor’s Degree in Social Work, Nursing, Gerontology, or related field
Must be bilingual English/Spanish
Ability to actively service areas in and around Palm Springs, Coachella, and Hemet
3+ years of experience in managed care or healthcare environment
Demonstrated knowledge of assessment, health and functional problems of older adults and managed care
Knowledge of community resources for seniors
Basic knowledge of related NCQA standards, CMS and DHS regulations
Excellent written and oral communication skills, as well as strong interpersonal, critical thinking and analytical skills
Excellent organizational, decision-making and multi-tasking skills
Demonstrated customer focus; proactively finds ways to exceed customer needs
Demonstrates keen attention to detail and produces high quality work products
Ability to prioritize multiple and competing tasks, work independently and in a team environment
Ability to work well in a fast-paced and dynamic environment
Proficient in MS Office
Must maintain valid drivers’ license, automobile insurance and have reliable transportation.
Your preferred qualifications
Master’s Degree in Social Work (MSW)
Conditions of work
Monday-Friday, 8am to 5pm. Extended work hours, as needed
Requires bi-monthly office visits to Long Beach
What's in it for you?
A competitive compensation and benefits program;
An annual employee bonus program;
Robust Wellness Program;
Generous paid-time-off (PTO);
Ten paid holidays per year;
Excellent 403(b) Saving Plan, providing up to 4 % match and vesting after three years;
Robust employee recognition program.
A Work - life balance and much more!
We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!
Our mission is simple: Keeping Seniors Healthy and Independent–that’s been our mission for almost 40 years. Rated as one of the top Medicare Advantage plans in California, SCAN Health Plan employees are passionate about what they do. Understanding that success is based on achieving the mission, SCAN employees are afforded with the training and tools necessary to do their jobs and they are rewarded... for their efforts and recognized as experts in their fields. Ask anyone who works here and we’ll proudly tell you that SCAN’s commitment has never wavered. We are as steadfast in our pledge to help our members live healthy and independent lives.