Bilingual Spanish RN, Care Management (Riverside)

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next‑generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve. Position will work in remote & in the field in Riverside, CA & the surrounding areas The Job The Registered Nurse (RN) – Care Management is a clinically accountable role responsible for delivering high‑touch, person‑centered care management to members with complex medical needs who cannot be effectively supported through telephonic care management alone. The RN conducts in‑home and telephonic assessments, develops and manages individualized care plans, educates members and caregivers on disease processes and self‑management, and collaborates with an interdisciplinary care team to stabilize risk and improve health outcomes. The RN serves as the clinical lead, coordinating care across providers and settings to promote safe, effective, and timely care. You Will Conduct comprehensive clinical, functional, and environmental assessments in members’ homes and via telephonic encounters, based on clinical risk and acuity. Identify clinical, functional, medication, caregiver, and environmental risks that may impact member stability or safety. Work collaboratively with Social Workers, Community Health Workers, Care Coordinators, and other interdisciplinary team members to address medical, psychosocial, and environmental barriers to health. Participate in case reviews, huddles, and interdisciplinary discussions to support coordinated, member‑centered care. Develop, implement, and regularly update individualized care plans with measurable goals focused on member priorities and health outcomes by evaluating assessment findings against evidence‑based guidelines, clinical reasoning, and best practices. Integrate clinical insights and community standards to develop comprehensive and effective care strategies. Provide disease‑specific education, coaching, and self‑management support to members and families, using teach‑back to confirm understanding. Support medication safety through medication reconciliation, adherence assessment, and coordination with providers and pharmacy resources when needed. Coordinate care with primary care providers, specialists, hospitals, skilled nursing facilities, home health, and community resources to ensure continuity of care. Demonstrate organizational, decision‑making, critical thinking, and multi‑tasking skills as demonstrated by problem solving and achieving successful member outcomes. Adhere to all SNP Model of Care requirements and procedures. Complete timely and accurate documentation across multiple computer systems, including care plans, service plans, and progress notes as necessary within established timeframes. Manage transitions of care following emergency department visits, hospitalizations, or facility discharges, including follow‑up, risk mitigation, and education on red‑flag symptoms. Comply with all compliance, regulatory and quality agency standards including Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DHC), and Department of Health Care Services (DHCS). Perform nursing related California Integrated Care Management (CICM) activities related to specific Populations of Focus (POF): Individuals Experiencing Homelessness, Individuals At Risk For Avoidable Hospital Or ED Utilization, Adults Living In The Community At Risk Of LTC Institutionalization, Adult Nursing Facility Residents Transitioning Back To The Community, Documented Dementia, Serious Mental Illness (SMI) & Substance Use Disorder (SUD). 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. Other duties as assigned. Your Qualifications Bachelor’s degree in nursing (BSN) required. CA Registered Nurse (RN) required. Graduate or Advanced Degree or equivalent experience preferred. Certified Case Manager (CCM) certification strongly preferred. BILINGUAL required in English/Spanish. (Test will be administered to assess proficiency if applicable.) Travel 50+% of the time in the assigned area – Must have a valid driver’s license, automobile insurance and reliable transportation. 3+ years clinical experience in care management, case management, home health, community‑based care, or a related clinical setting preferred. 2+ years working with seniors and hybrid remotely strongly preferred. Experience working with high‑risk, complex, or chronically ill populations preferred. Leadership – Skilled to develop others. Problem Solving – Make critical decisions, often involving high‑level risk assessment and the ability to adapt to changing circumstances. Strategic Mindset – Formulates strategy and maps steps to achieve strategic goal. Strong interpersonal skills, including excellent written and verbal communication skills. Strong organizational skills. Strong critical thinking skills. Ability to multitask. Ability to appropriately maintain confidentiality. General understanding of NCQA standards, CMS and DHCS regulations. General knowledge of medical terminology and abbreviations. Deep understanding of local community resources for seniors. Tuberculosis Screening Policy 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. What’s in it for you? Base salary range: $44.42 to $61.20 per hour Work Mode: Hybrid An annual employee bonus program Robust Wellness Program Generous paid‑time‑off (PTO) Eleven paid holidays per year, plus 1 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! Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more. SCAN is proud to be an Equal Employment Opportunity and affirmative action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required. The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information, 41 CFR 60‑1.35(c). #J-18808-Ljbffr SHPCA SCAN Health Plan