Healthcare Operations Manager

3 days ago

Long Beach, California, United States SCAN Full time

About SCAN Group, a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. Our mission is to keep seniors healthy and independent for over 45 years.

The Job:

**Job Summary:**

">">">As a Care Management Director at SCAN Group, you will oversee daily operations and continuous quality improvement of care management programs to ensure delivery of high-quality, evidence-based care with a focus on addressing medical, behavioral health, and social needs of members. You will manage teams and programs that help achieve excellent health and support provider and member engagement. This role requires strong leadership skills, attention to detail, and ability to work collaboratively with various stakeholders.

Responsibilities:

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  • Oversight of care management teams to drive operational excellence and productivity.">
  • Participation in establishing strategic plans and objectives; collecting and monitoring performance; developing dashboards and reports; and developing and evaluating programs and projects that promote health, improve member engagement, and address holistic member needs.">
  • Ensuring department policies and procedures, desktop procedures, workflows, job aides, training materials, are current and accurately reflect processes in order to provide consistent quality care in compliance with department requirements.">
  • Collaboration with internal departments to ensure seamless care and support clinical and operational goals and create and review department metric reporting.">
  • Building effective professional relationships with providers and other internal and external partners utilizing verbal and written communication skills, developing trust, meeting timelines, respecting cultural differences, using active listening skills, and maintaining confidentiality.">
  • Serving as a subject matter expert and representing the department at assigned committees to support two-way communication between department and committee and committee to department head and/or staff as appropriate.">
  • Facilitating staff meetings and interdisciplinary team meetings.">
  • Promoting process improvement, quality assurance, and compliance with and adheres to all regulatory and quality standards including but not limited to: Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), and accreditation bodies' standards such as the National Committee for Quality Assurance (NCQA) as it relates to Complex Care Management activities.">
  • Consulting with a SCAN Medical Director when needed and offering recommendations to the care team for medical and/or behavioral health management at the appropriate level of care.">
  • Providing guidance and support with urgent and escalated issues.">
  • Acting as a resource to the Connecting Provider 2 Home team, MG care managers, physicians and other members of the healthcare team.">
  • Maintaining the member's right to privacy and protecting SCAN operations by keeping information confidential.">
  • Accomplishing results by communicating to staff job expectations; planning, monitoring, and appraising job results; coaching and counseling employees; initiating, coordinating, and enforcing systems, policies, and procedures.">
  • Maintaining staff by recruiting, selecting, orienting, and training employees; maintaining a safe and secure work environment; developing personal growth opportunities.">
  • Maintaining professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, participating in professional societies.">
  • Contributes to the team effort by accomplishing related results as needed.">
  • Actively supports the achievement of SCAN's Vision and Goals.">
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Qualifications:

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  • Bachelor's degree. BSN or MSN preferred.">
  • Current & Active Registered Nurse (RN) License.">
  • Medicare/Medi-Cal experience in managed care environment.">
  • 2+ years of supervisory or management role required.">
  • 2+ of case management experience in a medical group, IPA and/or HMO setting preferred.">
  • Bilingual Spanish strongly preferred. A test will be administered if applicable.">
  • Strong written and oral communication skills, as well as strong interpersonal, critical thinking, and analytical skills.">
  • Demonstrated ability to work with all levels of staff, within and external to the organization to achieve goals.">
  • Experience with coordinating diverse groups of individuals to achieve success of the overall program.">
  • Ability to prioritize multiple and competing tasks.">
  • Ability to work independently or as a team while working in a fast-paced and dynamic environment.">
  • Basic knowledge of related NCQA standards, CMS and DHCS regulations.">
  • Medical and clinical terminology conversant.">
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What's in it for you?

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  • Estimated salary range: $106,200 to $169,900 per year.">
  • Internal Title: Mgr Connecting Prov2Hm.">
  • Remote Work Mode.">
  • 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.">
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We're an equal opportunity employer.

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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.

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