About SCAN

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, and Nevada. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 40 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn, Facebook, and Twitter.

The Job

The Personal Assistance Line (PAL) Specialist is the single-point of contact for all assigned dual members (Medi-Cal/Medicare). The PAL Specialist manages all initial and annual outreach to each assigned member, supports member understanding, access to integrated SCAN benefits and community services/programs, conducts Health Risk Assessments (HRAs), completes member Care Plans, resolves member service issues, and proactively assists members in navigating through healthcare and state eligibility systems. The PAL Specialist facilitates access to care with/on behalf of the member and engages clinical support (internal and external) for escalated member issues/care needs, and functions as a liaison between members, SCAN Health Plan, Medical Groups, Medi-Cal, providers and community based organizations.

You Will

Responsible for managing caseload of assigned Connections and Connections at Home members, including outbound call activity, as assigned, and prompt response to all inbound member calls.

Conducts assigned member welcome and follow-up calls designed to assist members with access to appropriate benefits, educate members, family and caregivers regarding benefit provisions, facilitate referrals, and resolve member issues with health care providers (medical, dental, vision and other supplemental benefits).

Conducts Continuity of Care assessments and facilitates member access to care.

Actively engages and collaborates with member to complete Health Risk Assessments, assisting member to identify health needs, and collaborating with member to develop health goals and create member plan of care.

Contributes to member satisfaction and retention by developing rapport, identifying member needs, making appropriate referrals, providing assistance and resolving escalated member issues.

Identifies quality concerns and works with Health Care Services,Quality Management staff and Provider Group Care Management to expedite the resolution.

Documents transactions by completing assessments, applicable forms and summarizing actions in computer system.

Understands the health plan’s benefit structure, medical group resources, community programs and resources and member-specific needs to proactively problem-solve and identify member-centered solutions.

Adheres to all quality, compliance and regulatory standards to achieve Health Care Services and SCAN outcomes.

Actively support the achievement of SCAN’s Vision and Goals.

Other duties as assigned.

Your Qualifications

• High School Diploma / G.E.D. certificate required, Associate's Degree or higher preferred.
• Bilingual - Must be bilingual in English and Spanish, Korean, or Chinese (Test will be administered to assess proficiency).
• 2+ years of experience in healthcare, insurance, or medical group preferred with direct service to seniors or persons with disabilities, and knowledge of issues that face members with special needs.
• HMO and/or Medi-Cal experience is preferred.
• Customer service, call center or hospitality experience preferred.
• Knowledge of appropriate techniques to serve members from diverse social and ethnic groups.
• Demonstrated critical thinking and problem solving skills to get to the heart of the member’s issue.
• Knowledge of Motivational Interviewing techniques. Ability to apply skills to address complex member concerns and find member-focused solutions.
• Ability to handle large call volume, while providing excellent customer service at all times.
• Demonstrated efficiency/effectiveness in an environment with high volume, handling complex calls/ issues.
• Ability to listen, talk and type at the same time.
• Ability to build trust, respect and credibility with all partners through full, honest, consistent, and coordinated communication.
• Demonstrated time management and priority setting skills.
• Strong interpersonal and organizational skills.
• Excellent written and verbal communication skills.
• Ability to multitask.
• Ability to maintain calm demeanor at all times including during emotionally-charged conversations.
• Ability to work in an environment where continuous coaching and feedback is the standard practice.
• Ability to appropriately maintain confidentiality.
• Knowledge of principles and practices of health care service delivery and managed care, as well as knowledge of Medi-Cal eligibility and benefits is preferred.

Covid-19 Vaccination Policy

To ensure a healthy and safe work environment, if you are selected for this position, your job offer with SCAN Health will be contingent upon being fully vaccinated and providing proof of your COVID-19 vaccine within 3 days after your start date. Generally, you are considered fully vaccinated 14 days after receiving the last dose, as recommended by the manufacturer, of a vaccine that has been authorized by the FDA for use in the United States, including vaccinations that have been approved pursuant to an Emergency Use Authorization. If fully vaccinated outside of the United States, the vaccination must be listed for emergency use by the World Health Organization (WHO). If you cannot receive the vaccine because of a disability/medical reason or sincerely-held religious belief, you may request an accommodation to this requirement by contacting COVID-19 Vaccination Policy. Learn more about the COVID-19 vaccination here - https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html

What's in it for you?

• Base salary range: $23.50 to $37.59 / hour
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• Ten paid holidays per year, plus 1 additional floating 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!

We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!

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.

#LI-CS2

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

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)