Demo

Program Director, Quality & Compliance

HealthCHEC
Long Beach, CA Full Time
POSTED ON 2/4/2025
AVAILABLE BEFORE 5/3/2025

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 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 www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn; Facebook; and Twitter.

The Job

The purpose of this role is to facilitate the planning, design, and implementation of programs (groups of projects) that are linked through common departmental or organizational goals and strategies. The Program Manager combines analytical thinking, business knowledge and program management skills to develop the framework for execution to make certain the programs are aligned with the organization's larger strategy, completed timely, within budget, and in alignment with identified goals.

You Will

  • Lead programs (group of projects) that are linked through common departmental or organizational goals and strategies including those related to the Quality Improvement Program, Quality monitoring and oversight and regulatory requirements.
  • Lead operational readiness for NCQA accreditation in partnership with business leads.
  • Implements SCAN's cross-functional Quality Improvement Program Description, Quality Improvement Work Plan,
  • Quality Program and Work Plan Evaluation and Compliance program in support of the organization's mission and goals.
  • Ensure Quality Improvement program is in compliance 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).
  • Partner with business areas to operate in a manner that is consistent with continuous quality improvement
  • Articulate vision, goals and objectives for the organization, especially as it relates to the assigned program. As a self-starter drive strategic projects and ensure deliverables are aligned with the organization's larger strategy.
  • Manage the execution of strategies through program design and implementation, ensuring strategic alignment with executive-level partner(s).
  • Manage multiple projects and assignments under the umbrella of the associated program (that are cross-functional and multi-disciplinary), serving in a project leadership capacity. Assemble project teams, collaborate on individual responsibilities, develop project schedules, and determine resources needed to achieve milestones and overall objectives / outcomes.
  • Ensure change management feasibility, plan and implement accordingly. Develop effective communication strategies to facilitate initiative rollout. Deliver notifications and program / project updates to affected parties. Keep internal and external stakeholders informed of progress, challenges, and barriers.
  • Identify and manage risks associated with individual projects and overall program, develop and implement mitigation strategies to remove barriers.
  • Plan, monitor, and adapt program success based on outcomes. Develops and oversees policies and processes for operational efficiency and program quality.
  • Facilitate senior management decision making by analyzing strategic alternatives and developing recommendations.
  • Other duties as assigned.

Your Qualifications

  • Bachelor's degree or a comparable combination of education / experience and / or training will be considered equivalent to the education listed above.
  • 5 years of project or program management, with an Intermediate to Advanced understanding of project management principals.
  • Knowledge of related NCQA standards, CMS and DHS regulations.
  • Knowledge of health care quality metrics.
  • Demonstrated capability of panning for short- and long-term range goals
  • Moderate to strong skills in quantitative analysis, qualitative analysis, and problem-solving
  • Analyzing internal / intra-departmental processes
  • Effective verbal and written communication skills, catered to a variety of audiences at various levels
  • Managing competing priories and expectations across multiple stakeholders, ability to manage a variety of projects simultaneously
  • Demonstrated understanding of healthcare industry
  • Ability to develop and maintain positive relationships and facilitate the exchange of information across business units
  • What's in it for you?

  • Base Pay Range : $125,400 - $ 200,600 (Annually)
  • Work Mode : Mostly Remote
  • An annual employee bonus program
  • Robust Wellness Program
  • Generous paid-time-off (PTO)
  • 11 paid holidays per year, plus 1 additional floating holiday
  • Excellent 401(k) Retirement Saving Plan with employer match
  • 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-AC1

    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)

    Salary : $125,400 - $200,600

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