Advanced Practice Clinician, Integrated Care Delivery (San Bernardino County)

Job description

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. Job Description: *Will cover a certain geography within San Bernardino County The Job The Advanced Practice Clinician will provide and coordinate primary care to SCAN members to achieve the Company’s mission to keep seniors healthy and independent. We hire for this role on a rolling basis. If you're a match, we’ll reach out when a position becomes available. You Will Provide care to an assigned panel of members (patients) in their place of residence, most commonly in senior living communities or skilled nursing facilities. This includes conducting physical/wellness exams and assessments; occasional urgent medical visits and telephonic triage to ensure timely, appropriate care and hospital avoidance if possible; administering vaccines; ordering and interpreting diagnostic tests; initiating goals of care conversations with patients and their loved ones; and chronic disease management. Identify patient health care needs and develop a comprehensive plan of care for the patient, their family, and living-community staff. Collaborate with our case management team to ensure members have timely access to necessary and appropriate services. Independently manage visitation schedule in line with established practice protocols and adjust schedule based on members’ needs and acuity. Engage with Primary Care Physicians and other health care professionals in a collaborative relationship aimed at disease prevention, health promotion, and chronic disease management. Partner closely with Primary Care Physicians for clinical oversight and guidance. Connect with specialists, hospitals, ancillary care providers, and community-based organizations to ensure continuity of care and promote shared decision-making while advocating for members. Actively monitor and quickly address clinical quality gaps in care in partnership with other care providers. Document member visits and interactions in a timely manner according to established practice protocols. Serve as an ongoing direct resource for members and their families, as well as for their communities and support staff. Participate with Integrated Care Sales team in events to build member awareness and educate communities. Initiate and complete virtual health visits with members as needed to promote accurate triaging and reduce drive time. Participate in on-call program available to our members after hours and on weekends. Maintain professional and technical knowledge by attending educational workshops and reviewing professional publications. Contribute to team efforts to meet quality healthcare goals by closing care gaps, attending high risk group discussions, and optimizing clinical workflows and protocols. This position is a patient-facing role. Employees may be eligible for differential pay. 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 Master’s degree in Nurse Practitioner Certificate OR Master’s from an accredited PA program, Education in Adult/Geriatric medical care preferred. A comparable combination or education/experience and/or training will be considered equivalent to the education listed above. Current California Nurse Practitioner license OR California Physician Assistant Certification (PA-C) in good standing. Wound Care Certificate and Palliative Care Certificate a plus. Knowledge of the treatment of complex chronic diseases, such as dementia, diabetes, heart failure, and COPD. Ability to identify health care needs and refer and coordinate with other resources/programs appropriately. Knowledge of HCC and ICD-10 coding and documentation. Knowledge of wound care and management. Knowledge of CMS guidelines and Medicare Advantage Managed Care. Comfortable with initiating goals of care and end of life discussions. Strong interpersonal skills and change agent mindset needed to build relationships with healthcare team and patients. Knowledge of and ability to maintain HIPAA requirements. Adaptable and open to change and problem-solving. Knowledge of and/or ability to learn basic technological skills (Word, Excel, PowerPoint, Outlook, EMR) and open to new technology. Ability to stoop, kneel, and crouch required. Ability to bend, reach, lift, pull, push, and carry up to 10 lbs. regularly and up to 50 lbs. occasionally. Multilingual/Multicultural a plus. Travel 75+% of the time in the assigned area- Must have a valid driver’s license, automobile insurance and reliable transportation. 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: $ 125,400.00 to $ 179,300.00 annually Quarterly bonus program Robust Wellness Program Generous paid-time-off (PTO) Eleven 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-BB1 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)