Program Manager, Cost of Care
 SCAN Group | |
paid holidays, tuition reimbursement, 401(k), remote work
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 United States, California, Long Beach | |
 Jan 17, 2025 | |
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Description
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 280,000 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. The Job The Program Manager, Cost of Care, is responsible for driving impactful cost-management initiatives specifically for SCAN's at-risk provider arrangements, aiming to reduce healthcare expenditures while improving member outcomes and satisfaction. This role focuses on strategic problem solving, utilizing data-driven insights to identify cost drivers, manage utilization trends, and monitor the performance of SCAN's value-based provider contracts. The Program Manager will collaborate cross-functionally with internal SCAN departments, including but not limited to finance, network management, provider relations, and clinical, to design and execute innovative cost-saving strategies, provide actionable insights to senior leadership, and ensure that programs align with SCAN's mission and goals. You Will Analyzes cost of care trends: Utilizes available data to identify cost drivers, assess utilization patterns, and uncover opportunities for SCAN to enhance quality and reduce expenditures, focusing on high-impact areas. Leverages prior experience to suggest additional reporting or analytics tools that would improve performance. Develops cost-saving strategies: Formulates strategic initiatives with a focus on Medicare Advantage by collaborating with finance, network management, and clinical teams to address high-cost areas, yielding measurable cost reductions. Manages performance of value-based provider contracts: Collaborates on the development, negotiation, and implementation of value-based provider contracts, ensuring alignment with SCAN's mission, to improve outcomes while controlling costs. Facilitates cross-functional collaboration: Coordinates with clinical, operational, compliance, and finance teams to drive effective implementation of cost of care programs, focusing on scalability, operational excellence, and maximizing value-based contract performance. Monitors program performance metrics: Tracks key performance indicators (KPIs) for SCAN's at-risk book of business, value-based contracts, and clinical programs, identifying improvement areas and providing concise, actionable report outs to senior leadership. Conducts financial impact and ROI analysis: Partners with the finance department to analyze the financial and return-on-investment (ROI) impact of value-based contracting and clinical initiatives, supporting budgeting and forecasting for ongoing and new projects. Prepares and presents program reports: Creates detailed reports and presentations for stakeholders, summarizing program impacts, cost trends, and strategic recommendations to address plan challenges. Leads strategic problem solving and continuous process improvement: Drives efforts to refine cost management practices within SCAN, fostering a culture of continuous improvement through innovative solutions and data-informed strategic problem solving. Supports development of playbooks for performance improvement based on identified areas of opportunity using KPIs. All other duties as assigned. Your Qualifications Bachelor's Degree or equivalent experience Previous experience in a health plan or Accountable Care Organization (ACO) managing cost of care trends. 5 years of experience in a provider performance management role. 2-3 years of leadership experience. Familiarity with healthcare and managed care required. Familiarity with healthcare markets of support, preferred. Leadership - Skilled to develops others Problem Solving - Good problem-solving skills Optimizes Work Processes - Identifies and creates processes necessary to get work done Self-starter who can initiate and lead projects as well as navigate different environments. Strong analytic, quantitative, and problem-solving skills required. Strong verbal and written communication skills required. What's in it for you?
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. #LI-CS2 #LI-Remote 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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