Director, Clinical Operational Excellence

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 277,000 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. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn, Facebook, and Twitter.

The Job

This position will identify and implement strategies, processes, and technologies to drive operational excellence throughout the Health Care Services department to deliver high quality care and drive member satisfaction and excellent clinical outcomes. The Director will oversee the team’s reporting and analytics function and lead cross-functional strategic and operational projects on process redesign, technology implementation, and clinical model design, ensuring regulatory compliance for SCAN’s Model of Care and across department operations.

You Will

Oversee and drive the development, maintenance, and continual improvement of the Health Care Services’ reporting and analytics; help develop, baseline, and benchmark key performance indicators and operational metrics across the department and support the development of reports and dashboards.

Regularly review all reports and dashboards; call out important insights, connect insights to business impacts, and propose actionable strategies to stakeholders and leaders through quick updates and prepared presentations using storytelling and data visualizations.

Understand the business challenges within Health Care Services and lead strategic and operational projects and process redesign initiatives to drive operational efficiency, including oversight over complex cross-functional projects and Lean/Six Sigma process redesign initiatives.

Evaluate new and emerging technologies and oversee technology implementation to improve efficiency, improve member experience and retention, and improve clinical outcomes and service delivery (e.g. CRM, care coordination and care management platforms).

Collaborate closely with internal and external stakeholders in order to drive operational excellence and achieve goals; build effective professional relationships with providers and other internal and external partners utilizing verbal and written communication skills, developing trust, meeting timelines, respecting cultural differences, using active listening skills, and maintaining confidentiality.

Promotes compliance with the Special Needs Plan Model of Care across SCAN; promotes compliance within HCS and ensures that the business area operates in a manner that is consistent with continuous quality improvement to meet or exceed regulatory and quality standards including but not limited to: Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), and accreditation bodies’ standards such as the National Committee for Quality Assurance (NCQA).

Promotes compliance with all regulatory and accreditation standards ensuring that HCS policy and procedures, desktop procedures, workflows, job aides, training materials, are current and accurately reflect processes in order to provide consistent quality care and meet compliance with regulatory and department requirements; facilitating the review, update and/or development of HCS policies, procedures and processes as needed.

Acts as ongoing HCS representative with Compliance and serves as HCS representative during a regulatory agency site visit and is responsible for regulatory reporting and developing and fulfilling corrective action plans related to identified deficiencies.

Oversees HCS business continuity and disaster recovery activities by developing and maintaining processes carried out by HCS operational units that assure effective operations during down time and appropriate support of members’ health related needs during disaster.

Hires, trains, and coaches managerial and supervisory staff. This includes fostering of staff development, ownership, accountability, educational opportunities, team building, and career development.

All other duties as assigned.

Your Qualifications

Bachelor's Degree or equivalent experience

5-7 years of related experience

5 years of leadership experience

Leadership - Skilled to develops others

Business Insight - In-Depth understanding of the business

Problem Solving - Good problem-solving skills

Strategic Mindset - Creates strategies to sustain competitive advantage

Excellent presentation skills and group motivation skills.

Demonstrated leadership skills.

Strong healthcare program development and quality and analysis skills, including understanding basic research methods.

Strong skills for evidence-based decision making.

Strong strategic planning and critical thinking skills.

Ability to build positive relationships with all levels or the organization.

Strong oral and written communication skills.

What's in it for you?

• Base salary range: $125,400 to $200,600 per year
• Internal Job Title: Director, Health Care Services
• 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!

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-CS2

#LI-Remote

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)