Network Relations Manager - Central & Northern California
: Job Details :


Network Relations Manager - Central & Northern California

SCAN Healthplan

Location: San Francisco,CA, USA

Date: 2024-11-13T08:41:24Z

Job 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 285,000 members in California, Arizona, Nevada, and Texas. 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

Manages the relationship and partnership development with SCAN providers in a Global or Full Risk arrangement.

The Network Relations Manager will be responsible for building and maintaining effective provider relationships with medical groups and their associated primary care physicians, specialists, hospitals and ancillaries. This role will manage a team of locally based Network Relations individuals across SCAN's geographic markets. The focus for this team is on medical groups who are in a Global or Full Risk capitated delegated arrangement with SCAN.

The job entails partnering closely with Network Management Contracting counterparts to facilitate an integrated onboarding process, conducting provider awareness and orientation about SCAN Health Plan, ongoing education and outreach, relationship building with office staff and providers, and quarterbacking the overall relationship including acting as the liaison with cross-functional stakeholders across reporting needs, performance monitoring, issue resolution, and clinical programs or growth efforts with the medical group and their providers.

There will be daily interface with office staff and providers, as well as interactions with corporate leadership at medical groups and constant collaboration with internal stakeholders to effectively establish and maintain a positive provider experience and resolve escalated issues in a timely manner.

You Will

* Serve as primary contact for medical groups and their associated primary care physicians, specialists, hospitals and ancillaries and act as a key liaison between the group/providers and health plan.

* Closely partners with Network Management Contracting to facilitate an integrated onboarding experience, leading project management planning for cross-functional onboarding efforts and establishing a robust playbook.

* Establish and maintain excellent relationships with the provider network, with in-market travel to meet with medical group corporate leadership/providers and support the locally based Network Relations individual(s) as needed.

* Manage oversight of the locally based Network Relations team including tracking of office staff and provider orientations, ongoing education and engagement tactics, quality and performance trainings and participation in relevant programs, driving growth strategies, as well as relationship building both virtually and via onsite visits.

* Investigates and responds to escalated provider concerns and issues. Monitors trends or insights and partners with Network Operations on developing new processes for improvement.

* Represents as a key business leader for driving forward initiatives to improve the provider experience with SCAN. Supports creation and improvement of templates for educational materials and formal presentations to support provider touchpoints and initiatives.

* Partners with cross-functional teams to have quality performance monitoring of the provider network, and liaison for actions that need to be taken for improvement or learnings. Coordinates data extracts and data analysis interpretation.

* Partners with other in the Network Management department on having a pulse of network adequacy and robustness of local provider access and reputation to evaluate the need for additional providers; supports on internal awareness of network changes. Acts as a key liaison for network needs to support clinical programs or growth efforts.

* Ensures SCAN and its contracted medical groups and providers follow regulatory requirements.

* Supports or leads on internal company initiatives/projects/process improvements that further improve provider experience.

* All other duties as assigned.

Your Qualifications

* Bachelor's Degree or equivalent experience

* 5+ years of related experience in healthcare or Medicare Advantage products, programs, services and/or business operations.

* 3+ years of experience managing a team.

* Experience in the Health Care industry is strongly preferred.

* Excellent project management skills with experience in expediting large, complex and/or long term projects.

* Ability to collect large magnitude of business subject matter knowledge and connect dots across the organization.

* Strong analytical skills with the ability to use statistical tools and interpret and apply the results.

* Strong platform and presentation skills.

* Strong multi-tasking and organizational skills with minimal supervision. Team-player, innovative, problem solver, detail oriented. Ability to execute work under pressure and tight deadlines.

* Organizational skills. Analytical thinking skills. Mathematical skills. Statistical knowledge. Detail oriented.

* Leadership skills. Judgement. Creativity.

* Excellent problem solving skills with the ability to find creative solutions for issues where the answers are not clear.

* Highly developed quantitative, oral, written and interpersonal communications skills with the ability to effectively convey information in a clear and concise manner.

* Proactive and independent thinker.

What's in it for you?

* Base Pay Range: $106,200.00 - $169,900.00

* Work Mode: Mostly Remote

* An annual employee bonus program

* Robust Wellness Program

* Generous paid-time-off (PTO)

* 11 paid holidays per year, plus 1 additional floating 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!

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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