What are the responsibilities and job description for the VP, General Manager position at HealthCHEC?

VP, General Manager

Location : Southern California

Reports to : President, Medicare

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 Vice President, General Manager is responsible for leading and driving the strategic, financial, and operational success of SCAN's Northern California markets. This executive leader has full profit and loss (P&L) ownership, ensuring that financial performance aligns with SCAN's corporate objectives while delivering high-quality, cost-effective healthcare solutions.

This role is accountable for market growth, provider network performance, financial sustainability, and regulatory compliance, while fostering strong partnerships with internal and external stakeholders. The VP, General Manager works cross-functionally with SCAN's shared services teams to ensure the development and execution of scalable, market-specific strategies that enhance membership growth, financial outcomes, and competitive positioning.

You Will

Market Leadership & P&L Management

Full P&L accountability for the Northern California markets, ensuring financial targets, revenue growth, and cost management objectives are met.
Oversee market expansion, membership growth, and competitive positioning to support SCAN's long-term strategic goals.
Lead the development and execution of multi-year business plans, ensuring alignment with SCAN's overall mission and financial objectives.
Drive operational efficiency and market-specific initiatives to optimize medical cost management and financial sustainability.

Strategic Planning & Execution

Define, implement, and execute the Northern California operating plan, integrating financial, operational, and growth strategies.

Lead market intelligence efforts to identify emerging opportunities, risks, and competitive trends, adjusting strategies to ensure continued success.

Represent the Northern California market in enterprise-wide strategic planning and corporate decision-making forums.

Drive collaboration across SCAN's business units, including finance, marketing, network management, and clinical operations, to ensure seamless execution of market strategies.

Market Growth & Expansion

Lead new market development efforts, assessing expansion opportunities and executing strategies that drive membership growth.

Identify and implement innovative approaches to enhance SCAN's market share, member retention, and value-based care initiatives.

Partner with internal teams to develop and implement targeted sales, marketing, and distribution strategies that drive enrollment growth.

Provider Network & Performance Management

Optimize provider network performance to achieve financial, operational, regulatory, and member satisfaction objectives.

Oversee provider contracting, negotiations, and incentive programs to maintain a high-quality, cost-effective provider network.

Lead initiatives to enhance provider performance related to medical cost, utilization management, risk adjustment, and quality outcomes (e.g., CMS Star Ratings).

Maintain strong relationships with providers, hospitals, brokers, and regulators to drive market success and compliance.

Operational Excellence & Continuous Improvement

Monitor, measure, and enhance market performance, leveraging data-driven insights to drive improvements.

Ensure adherence to SCAN's policies, procedures, and regulatory requirements, proactively addressing compliance risks.

Drive initiatives to reduce variation in performance, enhancing coding accuracy, risk adjustment, and overall medical benefit ratio (MBR).

Maintain a competitive cost structure while ensuring high-quality care and superior member experience.

Stakeholder Engagement & Market Representation

Serve as the primary market leader and spokesperson, ensuring strong engagement with external stakeholders, including state and federal regulators, industry groups, and community partners.

Represent SCAN's Northern California markets in corporate leadership meetings, strategic planning sessions, and external industry events.

Partner with SCAN's executive leadership team to influence corporate strategies based on market-level insights and performance trends.

Other Responsibilities

Lead cross-functional teams to execute key business initiatives, ensuring operational excellence and market success.

Champion a culture of innovation, accountability, and continuous improvement within the Northern California team.

Perform other duties as assigned by the SVP & General Manager, All Markets.

Your Qualifications

10 years of leadership experience in managed care, health plan administration, or provider network management, with P&L responsibility.

Proven track record of driving profitable growth, market expansion, and financial performance in a highly regulated healthcare environment.

Strong expertise in network development, provider relations, value-based care, and financial management.

Demonstrated ability to develop and execute strategic plans, balancing operational execution with long-term growth.

Excellent communication, negotiation, and stakeholder management skills.

Experience with Medicare Advantage, CMS regulations, and risk-based payment models is preferred.

Proficiency in Microsoft Office and healthcare analytics tools.

Location : Southern California strongly preferred with travel required to meet with providers, partners, and stakeholders.

What's in it for you?

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.

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)

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