Program Manager, Cost of Care

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 280,000 members in California, Arizona, Nevada, Texas and New Mexico. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 45 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 Job The Program Manager, Cost of Care, is responsible for driving impactful cost-management initiatives specifically for SCAN's at-risk provider arrangements, aiming to reduce healthcare expenditures while improving member outcomes and satisfaction. This role focuses on strategic problem solving, utilizing data-driven insights to identify cost drivers, manage utilization trends, and monitor the performance of SCAN's value-based provider contracts. The Program Manager will collaborate cross-functionally with internal SCAN departments, including but not limited to finance, network management, provider relations, and clinical, to design and execute innovative cost-saving strategies, provide actionable insights to senior leadership, and ensure that programs align with SCAN's mission and goals. You Will Analyze cost of care trends: Utilize available data to identify cost drivers, assess utilization patterns, and uncover opportunities for SCAN to enhance quality and reduce expenditures, focusing on high-impact areas. Develop cost-saving strategies: Formulate strategic initiatives with a focus on Medicare Advantage by collaborating with finance, network management, and clinical teams to address high-cost areas, yielding measurable cost reductions. Manage performance of value-based provider contracts: Collaborate on the development, negotiation, and implementation of value-based provider contracts, ensuring alignment with SCAN's mission, to improve outcomes while controlling costs. Facilitate cross-functional collaboration: Coordinate with clinical, operational, compliance, and finance teams to drive effective implementation of cost of care programs, focusing on scalability, operational excellence, and maximizing value-based contract performance. Monitor program performance metrics: Track key performance indicators (KPIs) for SCAN's at-risk book of business, value-based contracts, and clinical programs, identifying improvement areas and providing concise, actionable report outs to senior leadership. Conduct financial impact and ROI analysis: Partner with the finance department to analyze the financial and return-on-investment (ROI) impact of value-based contracting and clinical initiatives, supporting budgeting and forecasting for ongoing and new projects. Prepare and present program reports: Create detailed reports and presentations for stakeholders, summarizing program impacts, cost trends, and strategic recommendations to address plan challenges. Lead strategic problem solving and continuous process improvement: Drive efforts to refine cost management practices within SCAN, fostering a culture of continuous improvement through innovative solutions and data-informed strategic problem solving. All other duties as assigned. Your Qualifications Bachelor's Degree or equivalent experience. Previous experience in a health plan or Accountable Care Organization (ACO) managing cost of care trends. 5 years of experience in a provider performance management role. 2-3 years of leadership experience. Familiarity with healthcare and managed care required. Familiarity with healthcare markets of support, preferred. Strong analytic, quantitative, and problem-solving skills required. Strong verbal and written communication skills required. What's in it for you? Base salary range:

$92,400

to

$147,800

per year. Internal Title: Program Manager. Mostly Remote Work Mode. An annual employee bonus program. Robust Wellness Program. Generous paid-time-off (PTO). Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday 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!

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