SCAN Health Plan
Director of Operations
SCAN Health Plan, Long Beach, California, us, 90899
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.The JobThe Director of Operations plays a critical role in driving operational excellence across Embrace’s pod teams and markets, overseeing both health plan and provider operations. Reporting to the Vice President/General Manager of Embrace, this role works closely with SCAN’s executive leadership and collaborates with key functional areas across the enterprise. The Director will lead care delivery operations, ensuring alignment with strategic goals while optimizing processes and leveraging data and technology to improve care quality, boost efficiency, and drive financial sustainability. This role will shape the future of care delivery for Embrace, ensuring members receive exceptional care while supporting SCAN’s long-term growth and success.You WillOperational Performance and Team Development:
Oversee daily operations to ensure pod teams deliver high-quality care, meet performance targets, and drive continuous improvement for care excellence.Member Services and Engagement:
Refine member services and call center operations to improve customer service and engagement. Collaborate with clinical and sales teams to deliver seamless service, using technology to enhance member experience and strengthen community relationships.Clinical Operations and Care Integration:
Lead clinical operations in collaboration with clinical and sales teams to meet the needs of members and communities. Ensure high clinical standards, resolve care issues, and drive continuous quality improvements.Performance Monitoring and Strategy:
Track KPIs and optimize care and operational models for efficiency and outcomes. Collaborate with leadership to implement scalable, strategic models aligned with the company’s long-term vision.Health Plan Management and Compliance:
Manage health plan offerings and key documents (ANOC, EOC, MOC) to ensure CMS compliance. Enforce regulations and quality standards while aligning operations with business goals and minimizing risk.Financial Oversight:
Oversee financial operations, including billing and revenue processes, ensuring budget adherence, optimizing revenue, and maintaining service quality.Utilization and Claims Operations:
Manage utilization and claims processes to ensure efficiency, accuracy, and contractual compliance.Network and Vendor Management:
Build and maintain relationships with contracted providers and vendors to enhance services and operational capabilities.Sales Support:
Partner with the VP of Sales to improve sales processes through market analysis, CRM management, and performance tracking.Market Expansion:
Collaborate with leadership and market leaders to drive geographic expansion, apply standardized practices, and support process improvements.Data-Driven Decision Making and Risk Management:
Leverage data and analytics to inform decisions, optimize processes, and mitigate operational risks.Team Culture and Leadership Development:
Foster a positive team culture, promote leadership growth, and encourage professional development within market teams.All other duties as assigned.Your QualificationsBachelor's Degree or equivalent experience preferred.8+ years of experience in healthcare operations management, preferably in a multi-site, primary care or mobile care setting.Experience with Model of Care and Care Management requirements, including CMS audit experience.Experience with mobile care delivery operations. Managing and leading geographically dispersed teams.Strong operational management and process improvement skills.Experience working in value-based care models is a plus.Excellent communication and organizational skills.Director level interpersonal, management, and communication skills.Strong strategic thinking skills to facilitate the development and delivery of new products and services to seniors and the community.Strong attention to detail, data-driven decision maker.Demonstrated leadership and management skills.Strong skills in remote team management.Proficient in MS Office.What's in it for you?Base salary range: $147,900 to $236,600 annually.Work Mode: Mostly Remote.An annual employee bonus program.Robust Wellness Program.Generous paid-time-off (PTO).Excellent 401(k) Retirement Saving Plan with employer match and contribution.Robust employee recognition program.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#LI-Hybrid
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Oversee daily operations to ensure pod teams deliver high-quality care, meet performance targets, and drive continuous improvement for care excellence.Member Services and Engagement:
Refine member services and call center operations to improve customer service and engagement. Collaborate with clinical and sales teams to deliver seamless service, using technology to enhance member experience and strengthen community relationships.Clinical Operations and Care Integration:
Lead clinical operations in collaboration with clinical and sales teams to meet the needs of members and communities. Ensure high clinical standards, resolve care issues, and drive continuous quality improvements.Performance Monitoring and Strategy:
Track KPIs and optimize care and operational models for efficiency and outcomes. Collaborate with leadership to implement scalable, strategic models aligned with the company’s long-term vision.Health Plan Management and Compliance:
Manage health plan offerings and key documents (ANOC, EOC, MOC) to ensure CMS compliance. Enforce regulations and quality standards while aligning operations with business goals and minimizing risk.Financial Oversight:
Oversee financial operations, including billing and revenue processes, ensuring budget adherence, optimizing revenue, and maintaining service quality.Utilization and Claims Operations:
Manage utilization and claims processes to ensure efficiency, accuracy, and contractual compliance.Network and Vendor Management:
Build and maintain relationships with contracted providers and vendors to enhance services and operational capabilities.Sales Support:
Partner with the VP of Sales to improve sales processes through market analysis, CRM management, and performance tracking.Market Expansion:
Collaborate with leadership and market leaders to drive geographic expansion, apply standardized practices, and support process improvements.Data-Driven Decision Making and Risk Management:
Leverage data and analytics to inform decisions, optimize processes, and mitigate operational risks.Team Culture and Leadership Development:
Foster a positive team culture, promote leadership growth, and encourage professional development within market teams.All other duties as assigned.Your QualificationsBachelor's Degree or equivalent experience preferred.8+ years of experience in healthcare operations management, preferably in a multi-site, primary care or mobile care setting.Experience with Model of Care and Care Management requirements, including CMS audit experience.Experience with mobile care delivery operations. Managing and leading geographically dispersed teams.Strong operational management and process improvement skills.Experience working in value-based care models is a plus.Excellent communication and organizational skills.Director level interpersonal, management, and communication skills.Strong strategic thinking skills to facilitate the development and delivery of new products and services to seniors and the community.Strong attention to detail, data-driven decision maker.Demonstrated leadership and management skills.Strong skills in remote team management.Proficient in MS Office.What's in it for you?Base salary range: $147,900 to $236,600 annually.Work Mode: Mostly Remote.An annual employee bonus program.Robust Wellness Program.Generous paid-time-off (PTO).Excellent 401(k) Retirement Saving Plan with employer match and contribution.Robust employee recognition program.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#LI-Hybrid
#J-18808-Ljbffr