SVP, Operations

Long Beach, CA, United States

Title: SVP, Operations

Type: Full Time

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 270,000 members in California, Arizona, and Nevada. 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 SVP, Operations is responsible for providing strategic leadership for and ensuring operational performance of the internal operations team by working with the President, Medicare and other management to establish long-range goals, strategies, plans, and policies. Departments reporting to this position include: Appeals and Grievance, Claims, Enrollment and Reconciliation, Premium Billing, Member Service and Experience, and Member Innovation

You Will

Responsible for direction and coordination of the operational functions, including defining, developing, implementing, and evaluating strategic plans, long and short-term organizational goals that ensure a functionally sound operations structure and continued viability.

Provide oversight in establishing objectives, policies, performance standards with a focus upon continuous improvement while strategically positioning the business for the future state and growth.

Identifies, recommends, and implements new processes, emerging technologies, and systems to improve and streamline organizational effectiveness.

Maintains operations by initiating, coordinating, and enforcing policies and procedures.

Provides leadership, and management of Member Services and Member Innovation by creating an environment of high expectations for customer services, efficient operations, and responsiveness.

Establishes the review of enrollment and reconciliation across product channels by aligning key assumptions with actual performance.

Provides leadership in establishing and maintaining account structures and fees schedules to ensure a streamline process (in the full cycle) of premium billing.

Identifies opportunities in the review of claims by establishing standards of review of duplicate claims using Centers for Medicare & Medicaid Services (CMS) evaluation as a guide.

Achieve financial goals in alignment with quality and compliance standards.

Contributes to team effort by accomplishing related results as needed.

Actively support the achievement of SCAN’s Vision and Goals.

Other duties as assigned.

Your Qualifications

Preferred but not Required: Master’s Degree in Business Administration, Public Health, Public Administration, related graduate degree, or equivalent work experience required. A comparable combination of education/experience and/or training will be considered equivalent to the education listed above.

15+ years Executive level experience with a progressive, consumer-oriented business. Preference will be given to those with previous experience and expertise as an executive in operations of an HMO or closely-related managed health care business, in Medicare, in health care and/or services for seniors.

Demonstrated capability of strategic thinking and planning for short- and long-range goals; strong analytical and management skills required.

Demonstrated expertise in executive level management and leadership.

Strong understanding of systems in a managed care setting.

Excellent interpersonal skills, including excellent written and verbal skills, communication skills, presentation skills and commitment to detail.

Ability to effectively meet with and present information to Board, clients, regulators, and other stakeholders.

What's In It For You

Competitive Base salary range between $300,000 - $350,000 and annual employee bonus program

Robust Wellness Program

Generous paid-time-off (PTO)

Eleven paid holidays per year, Plus your birthday and 1 additional floating holiday

Excellent 401(k) Retirement Saving Plan with employer match.

Robust employee recognition program

Tuition reimbursement

A work-life balance

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.

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