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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care coordination and management, ensuring high-quality and timely services for members while adhering to regulatory guidelines. Strong ability to build relationships and provide clinical guidance within an integrated care team framework.
Highest-signal resume keywords
Utilization ManagementPatient Status DeterminationCA LVN LicenseCare Management PrinciplesStrong Communication
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care CoordinationPre-Service ReviewConcurrent ReviewClinical GuidanceService Authorization
Soft Skills
Problem-SolvingDetail OrientedCustomer/Client FocusedResponsible
Certifications & Qualifications
Associate's DegreeCA LVN License
Industry Keywords
Integrated Care TeamHigh-Quality CareRegulatory TimeframesCare CoordinatorsSCAN Health Plan
About the role
Key responsibilities & impact- Coordinate care for members in collaboration with the Integrated Care Team
- Ensure members receive high-quality, timely, and coordinated care
- Authorizes services based on knowledge and skills in areas of utilization management, medical necessity, and patient status determination
- Conducts pre-service and concurrent review following established guidelines
- Applies care management principles and practices
- Serve as point person to speak with patients, family members, and providers
- Coordinate inpatient and outpatient care or services
- Issue determinations within required regulatory timeframes
- Develop effective working relationships and provide clinical guidance to Care Coordinators
- Promote the mission, vision, and values of SCAN Health Plan
Requirements
What you’ll need- Associate's Degree or equivalent experience
- 3-5 years of related experience
- CA LVN license
- Problem-Solving
- Strong Communication
- Customer/client focused
- Detail oriented
- Responsible
Benefits
Comp & perks- 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
