Network Management Operations Director (Remote, CA)

About SCANSCAN 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 285,000 members in California, Arizona, Nevada, and Texas. 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 , , or follow us on LinkedIn; Facebook; and Twitter.The JobThe Network Management Operations Director supports SCAN’s National Markets and the Network Management Department in developing processes, designing workflows, driving implementations, and supporting ongoing operations that impact SCAN’s providers and the teams engaging with providers. This position facilitates progress on key initiatives by building strong partnerships across the organization and managing effective communications. The Network Management Operations Director anticipates business needs and demands, and works to provide logical, innovative, and creative solutions.Position does not supervise anyone currently but may in the future.You WillWork with key leaders throughout the company to develop network management structure, processes, and systems that enable operational scalability, organizational growth and optimal performance outcomes.Drive and manage implementations and ongoing operations of network management strategies. Including but not limited to: Developing intra- and inter-department cross-functional processes and improvements. Designing and documenting workflows. Creating templates, presentations and communications needed to enable operational efficiencies,Driving execution of new processes to team members and relevant departments. Partnering with Network Administration team to enable training of team members and stakeholders on new processes and systems. Identifying any areas of inefficiencies that impact a provider (eg credentialing, directory display, onboarding, claims, auths, reporting, communications), identifying solutions and partnering with relevant stakeholders for improvements.Utilizing technologies and data algorithms to enable operational efficiencies. Lead business subject matter expert and/or project management of new network vendor implementations and tools such as CRM, Support implementation of regulatory compliance requirements impacting Network Management Operations.Key leader in supporting large cross-functional programs and being the established business owner to streamline and prioritize based on network needs. Creating reporting to track progress on strategic initiatives. Coordinating and owning relationships with internal and external partners to ensure SCAN operates at a level of excellence to be viewed as a provider’s Medicare Advantage payer of choice.Prepare detailed implementation plans inclusive of success metrics and criteria for deciding whether to replicate a strategy. Develop and maintain scalable playbooks for repeatable strategies. Assess key aspects of the company’s operations regarding progress towards quarterly and yearly objectives.Facilitate progress towards key objectives and assist in diagnosing and solving tactical problems that limit goal achievement. Prepare and review analytics to provide visibility to network operational strategies. Provide insightful, data-driven recommendations to optimize decision making. Monitor external communications and information resources for emerging trends and industry developments that inform adjustments to current network operational strategies.All other duties as assigned.Your Qualifications7+ years of related experience relevant to SCAN’s products, programs, services and/or business operations.5+ years of leadership experience.Experience in the Health Care industry is strongly preferred.Excellent project management skills with experience in expediting large, complex and/or long-term projects.Excellent problem-solving skills with the ability to find creative solutions for issues where the answers are not clear.Ability to collect large magnitude of business subject matter knowledge and connect dots across the organization.Strong analytical skills with the ability to use statistical tools and interpret and apply the results.Highly developed quantitative, oral, written and interpersonal communications skills with the ability to effectively convey information in a clear and concise manner.Strong platform and presentation skills. Proactive and independent thinker.Strong multi-tasking and organizational skills with minimal supervision.Team-player, innovative, problem solver, detail oriented.Ability to execute work under pressure and tight deadlines.What's in it for you?Base Pay Range: $125,400.00 - $200,600.00Work Mode: Mostly RemoteAn annual employee bonus programRobust Wellness ProgramGenerous paid-time-off (PTO)11 paid holidays per year, plus 1 additional floating holidayExcellent 401(k) Retirement Saving Plan with employer matchRobust employee recognition programTuition reimbursementAn 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-AC1#LI-RemoteJob SummaryRequisition Number: NETWO006565Job Category: Network ManagementSchedule: Full-Time