CVP, Network Management

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 300,000 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 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

Responsible for the overall financial and regulatory performance of SCAN's provider network. Develops and implements the strategic direction for SCAN's network and oversees network management operations to build and maintain a high performing provider network.

You Will

Defines long-term strategic goals for SCAN's provider network and develops clear plans to achieve them.

Oversees operations that develop and maintain positive relationships and financially viable contracts with medical providers. Engages contracted network leaders and establishes and maintains positive business relationships.

Negotiates contracts with high priority providers.

Collaborates with the SCAN Sales organization to execute company growth initiatives through the acquisition of new networks, providers, and vendors.

Accountable for provider performance related to financial, operations, regulatory, quality, and member satisfaction targets and other performance-related priorities.

Ensures providers understand and commit to performance goals. Leads key initiatives and collaborations that involve network partners.

Works across the SCAN organization, with clinical and administrative areas, to develop and deploy provider systems, standards, policies and procedures to improve network performance.

Oversees network administrative functions, including budget management, internal and external audit, regulatory compliance, contract administration, and policy and procedure enforcement.

Collaborates with SCAN senior leaders to establish and achieve financial and membership growth targets.

Contributes as a corporate leader by providing recommendations, direction and support of short and long-term company strategies.

Directs and supports staff to achieve organizational goals by communicating job expectations, planning, monitoring and appraising job results, coaching and counseling, driving increased employee engagement, and developing and maintaining succession plans.

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

Other duties as assigned.

Your Qualifications

• Bachelor's Degree in Business Administration, Public Health, Public Administration or related field of study. Master's Degree preferred. A comparable combination of education/experience and/or training will be considered.
• 10-15 years of experience in Managed Care with provider management and contracting is required.
• 5+ years of experience in an executive level position required.
• Expert knowledge of Medicare Advantage Products.
• Knowledge of industry standards, current trends and their application to a Medicare Advantage plan.
• Sound business and financial judgment with problem-solving abilities.
• High commitment to customer service.
• Executive presence and the ability to communicate at the Board Level.
• Exceptional interpersonal skills and excellent oral and written communication.
• Proven ability to interact effectively with all levels of the organization.

What's in it for you?

• Base Pay Range: $320,000.00 to $350,000.00 annually
• Work Mode: Mostly Remote
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO) along with 11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
• 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.

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