Manager, Clinical Operations (Orange County)

SCAN Health Insurance•Yountville, CA

3d•$106,200 - $151,910•Hybrid

About The Position

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: The Job The Manager, Clinical Operations, will oversee and optimize daily operations within clinical pods, process improvement in partnership with central operations, ensuring alignment with SCAN’s strategic goals, enhancing healthcare delivery, and maintaining high standards of patient care and operational efficiency. You Will The Manager, Clinical Operations, will be focused on clinical team (POD) management, this individual ensures seamless day-to-day operations and strategic alignment with SCAN’s initiatives. Their key responsibilities include: POD Process Implementation and Infrastructure Maintenance: Implement and maintain the infrastructure that supports daily POD operations, aligning with SCAN’s strategic initiatives, vision, and goals. Collaborate with central operations project teams to identify standardization opportunities and promote best practices. Healthcare Initiatives and Program Management: Design, implement, and manage new healthcare initiatives and programs to enhance the capabilities of the integrated care delivery program within PODs. Oversee panel management to ensure effective patient assignment, route optimization, and PCP relationships. Performance Monitoring and Analysis: Monitor and analyze POD performance metrics, including ADK, visits per day, open notes, notifications, documentation, and RAF scoring. Identify trends and collaborate with the APC manager and Medical Director on process improvements. Prepare reports on POD performance for leadership. Communication and Collaboration: Conduct regular touchpoints with the APC manager and Medical Director to review POD performance metrics, identify coaching or performance management opportunities, address operational issues, and ensure alignment with clinical goals. Foster positive relationships with communities and community partners to enhance collaboration and service delivery by rounding in POD communities. Patient Engagement and Quality Care Delivery: Perform in-person rounding at POD communities, collaborating with the APC manager to engage with APCs, address concerns, and ensure quality care delivery. Address regional member issues and concerns promptly and effectively, ensuring resolution and member satisfaction. Team and Vendor Management: Recruit, on-board, manage, and coach the team supporting clinicians. Communicate expectations clearly, monitor job performance, motivate, and develop opportunities for career growth. Manage regional vendor issues and relationships, including communication with community stakeholders and escalation to central management for resolution. Operational Efficiency and Compliance: Develop, update, and audit POD operations workflows to optimize efficiency, improve quality, and ensure compliance with regulatory standards. Adhere to all quality, compliance, and regulatory standards to achieve SCAN outcomes. 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.

Requirements

Bachelor’s or Master’s degree in healthcare or business-related field preferred. A comparable combination of education/experience and/or training will be considered equivalent to the education listed above.
Experience with Model of Care and Care Management requirements, including CMS audit experience required.
Experience with mobile care delivery operations required.
Manager level interpersonal, management and communication skills.
Strong diligence, data-driven decision maker.
Demonstrated leadership and management skills.
Strong skills in remote team management.

Nice To Haves

Experience with managed care preferred.

Responsibilities

POD Process Implementation and Infrastructure Maintenance: Implement and maintain the infrastructure that supports daily POD operations, aligning with SCAN’s strategic initiatives, vision, and goals. Collaborate with central operations project teams to identify standardization opportunities and promote best practices.
Healthcare Initiatives and Program Management: Design, implement, and manage new healthcare initiatives and programs to enhance the capabilities of the integrated care delivery program within PODs. Oversee panel management to ensure effective patient assignment, route optimization, and PCP relationships.
Performance Monitoring and Analysis: Monitor and analyze POD performance metrics, including ADK, visits per day, open notes, notifications, documentation, and RAF scoring. Identify trends and collaborate with the APC manager and Medical Director on process improvements. Prepare reports on POD performance for leadership.
Communication and Collaboration: Conduct regular touchpoints with the APC manager and Medical Director to review POD performance metrics, identify coaching or performance management opportunities, address operational issues, and ensure alignment with clinical goals. Foster positive relationships with communities and community partners to enhance collaboration and service delivery by rounding in POD communities.
Patient Engagement and Quality Care Delivery: Perform in-person rounding at POD communities, collaborating with the APC manager to engage with APCs, address concerns, and ensure quality care delivery. Address regional member issues and concerns promptly and effectively, ensuring resolution and member satisfaction.
Team and Vendor Management: Recruit, on-board, manage, and coach the team supporting clinicians. Communicate expectations clearly, monitor job performance, motivate, and develop opportunities for career growth. Manage regional vendor issues and relationships, including communication with community stakeholders and escalation to central management for resolution.
Operational Efficiency and Compliance: Develop, update, and audit POD operations workflows to optimize efficiency, improve quality, and ensure compliance with regulatory standards. Adhere to all quality, compliance, and regulatory standards to achieve SCAN outcomes.
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.

Benefits

Base Salary Range: $106,200.00 to $151,910.00 annually
Work Mode: Mostly Remote (Ideal candidate located in Orange County with about 20-30% travel in local area)
An annual employee bonus program
Robust Wellness Program
Generous paid-time-off (PTO)
11 paid holidays per year, plus 1 additional floating holiday, plus 1 birthday 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!
A competitive compensation and benefits program;
An annual employee bonus program;
Generous paid-time-off (PTO);
Eleven paid holidays per year;
Excellent Retirement Savings program;
A work-life balance;
An opportunity to become part of a team that makes a difference to our members and our community every day!