Role Description Supports the Medical Management department at SCAN by responding to provider calls and faxes, entering inpatient and related data into the case management system (CCMS), authorizing SCAN services under the direction of clinical staff and supporting the Medical Management clinical staff in securing information needed to ensure the delivery of quality care and services to SCAN members. You Will: - Support the authorization, monitoring and the processing of claims for inpatient and outpatient services by entering data into designated system and triaging events per department guidelines. - Maintain data entry requirements by following established workflows and departmental policies and procedures. - Verify member data by researching eligibility, member participation in SCAN Care Management Programs, benefits, network provider status, contracts and division of financial responsibility (DOFR). - Maintain telephone standards by answering calls within established turnaround times. - Serve as a resource for internal and external customers by ensuring services are provided within the benefit plan and utilizing contracted providers; work to develop a collaborative partnership with our network providers. - Ensure effective working relationships with providers by interacting in an appropriate, timely, professional manner, and promptly reporting any problems or issues. - Maintain the member‘s right to privacy and protect SCAN operations by keeping information confidential. - Utilize department desktop procedures, workflows, job aids and training material; identify barriers and bring to the attention of the supervisor/manager. - Communicate effectively with members by providing appropriate and timely information and by showing courtesy and respect each member, their caregivers and/or representatives. - Adhere to all quality, compliance and regulatory standards to achieve HCS and SCAN outcomes. - Contribute to team effort by accomplishing related results as needed. - Actively support the achievement of SCAN’s Vision and Goals. - Other duties as assigned. Qualifications - High School Diploma or equivalent required. Associate’s Degree or equivalent experience preferred. - 3+ years of medical experience in a managed care environment is preferred. - Proficiency with data entry required. - ICD-9, CPT coding experience preferred. - Knowledge of medical terminology is required. - Utilization Management experience is required. - Excellent communication skills; primarily telephonic required. - Working knowledge of Medicare and Medi-Cal guidelines preferred. - Strong organizational skills and the ability to prioritize. - Ability to multitask and work with limited supervision. - Ability to work well in a fast-paced and dynamic environment. - Ability to provide professional customer service. - Proficient in MS Office. Benefits - Base salary range: $20.14 to $27.77 per hour - Remote Work Mode - An annual employee 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 - 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!

• Provide high-level administrative support to senior leadership • Manage complex calendars and coordinate meetings • Arrange domestic and international travel • Prepare expense reports and handle confidential information • Support a variety of administrative and operational initiatives

• Post & Comment Tracking — Track all posts and comments from the group daily, using moderator-flagged posts as your starting point. • Maintain clean, structured records of all community activity for downstream reporting and trend analysis. • Moderation QA — Complete the daily FB Moderator QA checklist (approx. 1+ hour/day), reviewing shift records for completeness and flagging gaps. • Help ensure moderation quality stays consistent as the community scales. • Build toward cross-training as a backup moderator for coverage gaps. • Data Categorization & Reporting — Pull monthly exports of group statistics and engagement data from Facebook. • Clean, categorize, and upload data into Notion following established taxonomy. • Support the Social Health Dashboard by ensuring the right data flows into the right places. • Maintain organized archives of removed posts in formats digestible for leadership. • Growth & Initiative Tracking — Own weekly Growth Tracking — pulling in member data, post volume, and relevant moderator notes. • Compile post and data collections for specific initiatives (launches, giveaways, new products) with full impact views. • Flag emerging trends or patterns you notice in community activity. • Administrative Support — Assist with post scheduling, SH approval housekeeping, and ClickUp/Notion organization as needed. • Support the FB Health Dashboard as it develops.

• Perform a variety of administrative duties • Accurately and efficiently capture and input various forms of information into the company database • Keep all filing systems up to date • Provide support in a team-based environment • Communicate effectively with stakeholders • Respond to emails and phone calls • Schedule meetings • Book travel and accommodations • Manage a contact list • Prepare customer spreadsheets and keep online records • Create presentations as assigned • Meet team productivity and accuracy standards • Ensure confidentiality while handling sensitive information • Follow policies, procedures, and assigned workflows set by department leadership • Perform other administrative tasks and duties as needed