Provider Relations Lead (Northern/Central California)

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

The Provider Relations Lead will be responsible for building and maintaining effective provider relationships with medical groups, primary care physicians, specialists, hospitals and ancillaries. The Provider Relations Lead may focus on a particular provider type or geographic region, but will have skillsets to be agnostic and flexible based on business needs.

The job entails partnering closely with 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 group/provider.

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

• This position will perform work under no/minimal supervision while handling complex issues and problems and work complex issues with managers.
• The Provider Relations Lead will serve as primary contact for medical groups, providers, hospitals and ancillaries and act as a key liaison between the providers/entities and the health plan.
• Closely partners with 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 efforts focused on a particular region in which the Lead is based locally.
• The Provider Relations Lead conducts office staff and provider orientation, on-going education, training and relationship building both virtually and via onsite visits.
• Conducts regular provider office visits within assigned geographic region.
• Investigates and responds to escalated provider concerns and issues.
• The Provider Relations Lead participates in data driven operations meetings with assigned network of providers, corporate leadership and internal SCAN stakeholders.
• Creates educational materials and formal presentations to support provider touchpoints and initiatives.
• Supports cost and quality performance monitoring of the provider network, and liaison for trainings on deficiencies.
• Coordinates data extracts and data analysis interpretation.
• Partners with Contracting on 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.
• The Provider Relations Lead coordinates efforts to ensure SCAN and its contracted providers follow regulatory requirements.
• May provide leadership, coaching, and/or mentoring to group.
• Supports on internal company initiatives/projects/process improvements that further improve provider experience.
• Actively support the achievement of SCAN's Vision and Goals.
• Other duties as assigned.

Your Qualifications

• Bachelor's degree or combination of education/experience and/or training will be considered equivalent to the education.
• 3-5 years of prior relevant experience in a health plan, medical group or equivalent environment
• Knowledge of medical group, provider, hospital, ancillary contract language
• Knowledge of health plan, medical group risk arrangements strongly preferred
• Experience in Project Management
• Strong quantitative, written and oral communication skills including presentations, and interpersonal skills strongly preferred
• Ability to travel to meet with office staff and providers
• Ability to present in group settings, independently drive provider issues to resolution
• Strong multi-tasking and organization skills with minimal supervision
• Ability to execute work under pressure and tight deadlines
• Ownership mentality
• Ability to collaborate with various internal functional areas, be a team player, and cultivate business relationships with various constituents

What's in it for you?

• Base Pay Range (Annually): $71,700 - $114,700
• 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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