Sr. Manager, Quality Programs

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.

Job Description:

This role is responsible for managing, developing, and overseeing quality and clinical programs associated with organizational and department STAR initiatives. This role involves identifying quality program risks and developing a risk mitigation strategy, collaborating with various internal departments to implement best practices, and monitoring and reporting on program performance to ensure continuous improvement of STAR ratings and member outcomes.

As a key business leader, you will be responsible for managing, developing, and overseeing quality and clinical programs associated with organizational and department STAR initiatives. This role ensures the identification and management of quality program risks, the implementation of mitigation strategies, and the collaboration with various internal departments to develop and implement best practices that result in improved ratings and enhanced patient outcomes. The Manager will also monitor and report on program outcomes performance, KPI, delivering actionable insights, interventions, and impact to workgroups and committees.

You Will

Manage, Develop, and Oversee Quality and Clinical Programs: Lead the planning, implementation,and continuous improvement of quality and clinical programs aligned with organizational anddepartment STAR initiatives. Ensure that all programs meet regulatory and accreditation standards,and are designed to enhance patient care and satisfaction.

Identify and Manage Quality Program Risks: Conduct regular risk assessments to identify potentialissues and vulnerabilities in quality programs. Develop and implement risk mitigation strategies toaddress identified risks and ensure program integrity and effectiveness.

Collaborate with Internal Departments: Work closely with care management, customer service,outreach, product, sales, marketing, and other relevant departments to develop and implement bestpractice STAR initiatives. Facilitate cross-departmental communication and collaboration to ensurealignment and synergy in achieving quality and clinical goals.

Monitor and Report on Program Performance: Regularly monitor and analyze program performancemetrics to assess the effectiveness of quality and clinical initiatives. Prepare and present detailedreports to workgroups and committees, providing insights, interventions, and the impact of qualityprograms. Use data-driven insights to inform continuous improvement efforts and drive performanceenhancements.

Compliance and Regulatory Adherence: Ensure all quality and clinical programs comply withfederal, state, and local regulations and accreditation standards. Stay informed about industrytrends and best practices in quality and clinical management.

Continuous Improvement: Foster a culture of continuous improvement within the quality and clinicalteams. Encourage and support the adoption of innovative practices and technologies to enhanceprogram effectiveness.

Stakeholder Engagement: Engage with external stakeholders, such as regulatory bodies,healthcare providers, and community organizations, to build partnerships and enhance programimpact.

Supervises/Manages Others (i.e. hires, performance reviews, corrective action, etc.)

We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

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

Other duties as assigned.

Your Qualifications

Bachelor's Degree required.

Graduate or Advanced Degree or equivalent experience preferred.

MBA, RN or Pharm D. preferred

5 years of related experience.

3-4 years of leadership experience.

Experience in managing and improving quality metrics, particularly in the context of STAR ratings, is highly desirable.

Leadership - Skilled to develops others

Problem Solving - Make critical decisions, often involving high-level risk assessment and the abilityto adapt to changing circumstances

Strategic Mindset - Formulates strategy and maps steps to achieve strategic goals

Strong leadership and project management skills.

Excellent analytical and problem-solving abilities.

Effective communication and interpersonal skills.

Proficiency in data analysis and reporting tools.

Ability to collaborate and build relationships with diverse stakeholders.

Knowledge of healthcare regulations and accreditation standards.

What's in it for you?

• Base salary range: $125,400 to $181,419 per year
• Internal title - Sr. Mgr Care Quality Ops
• Work Mode - Mostly Remote
• 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.

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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)