*Position will work remote & in the field about 50% of the time in Riverside, CA & the surrounding areas*
Enhance seniors’ ability to manage their health and live independently by working with the care team to conduct home visits and patient assessments, advocating on behalf of the patient, communicating with the rest of the care team, and developing and implementing successful plans of care.
- Conducts in-home or telephonic visits to assess the patient and home environment to identify physical, social, emotional, and knowledge barriers to optimal care and adherence to clinical recommendations.
- Develops and implements a plan to address identified barriers in collaboration with patient, family and care team.
- Advocates for patients and families to help them receive the healthcare and assistance they need to remain as healthy as possible. Successfully helps patients and families to identify and utilize benefits and resources, including MediCal or SNP, drug subsidies, housing assistance or low-cost housing options, and transportation or caregiving.
- Supports advanced care planning and goals-of-care conversations, helping patients and families to set realistic goals given the patient’s medical condition. Educates patients and families on chronic disease management, health system navigation, and other health topics.
- Helps patients to coordinate primary or specialty care, lab, imaging or other health care appointments and transportation to/from these appointments.
- Exhibits strong interpersonal, critical thinking and analytical skills through positive communication and formation of strong working relationships with patients, caregivers, care team, and community agencies. Demonstrates excellent organizational, decision-making and prioritization skills as demonstrated by problem-solving and successful outcomes.
- Completes timely and accurate documentation in multiple computer systems to record assessments, observations and corresponding documentation, including care plans, and progress notes.
- Enhances skills and knowledge by participating in educational offerings, team case conferences and training, per department guidelines.
- Comprehensive knowledge of community and public resources serving the client population. Utilizes and adheres to department desktop procedures, workflows, job aids and training material. Identifies barriers to work processes and brings to the attention of the supervisor/manager.
- Maintains the client‘s right to privacy and protects SCAN and Medical Group operations by keeping patient information confidential.
- We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
- Actively support the achievement of SCAN’s Vision and Goals.
- High School Diploma or equivalent experience. Associate's Degree or equivalent experience preferred.
- Training or education in social work or benefits navigation preferred.
- Travel 50+% of the time in the assigned area- Must have a valid driver’s license, automobile insurance and reliable transportation.
- 2-3 years of related experience in managed care, healthcare environment, lived experience or case management.
- 1+ year working with seniors, conducting home visits, and working remotely strongly preferred.
- Bilingual Spanish proficiency is preferred but not required. Candidates without bilingual skills will be given full consideration based on their qualifications, experience, and ability to perform the essential functions of the role. (Test will be administered to assess proficiency if applicable.)
- Technical expertise
- Basic technical skills for functional area
- Communication
- Good communication and interpersonal skills
To ensure the health and safety of our members, if you are selected for this position, your job offer with SCAN will be contingent on providing proof of Tuberculosis screening upon hire or providing proof of a negative screening within the last year. If you have a disability/medical reason or sincerely held religious belief that prevents you to provide information required in this policy, SCAN will initiate and engage in the interactive process to evaluate what, if any, reasonable accommodations may be available.
- Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
- Excellent 401(k) Retirement Saving Plan with employer match and contribution