Chief of Claims & Provider Operations – Remote

SCAN Group; Long Beach (CA); Remote; USD 260,000 - 325,000; Full time

Benefits offered by this job

Remote work

Annual bonus

Wellness program

PTO

10+ holidays per year

401(k) with employer match

Tuition reimbursement

Job summary

SCAN Group is seeking a seasoned executive to lead Claims and Provider Operations in a remote-capable, strategic role. You will shape the operating model, drive cost efficiencies, and ensure regulatory compliance across multiple programs.

You will manage a broad team, align with enterprise goals, and deliver measurable improvements in accuracy, speed, and provider experience while steering a large budget and leveraging AI and analytics.

Qualifications

• Bachelor's Degree or equivalent experience.
• 10-15+ years healthcare operations leadership experience.
• Experience leading large teams and complex transformation programs.
• Strong knowledge of claims processing, editing, provider data, and compliance.

Responsibilities

• Leads claims intake, adjudication, configuration, provider data operations, and payment integrity.
• Owns end-to-end accuracy, timeliness, and control performance across claims and provider operations.
• Leads transformation through automation, AI, analytics, and process redesign.
• Partners with IT, Finance, Compliance, and other teams to optimize system configuration and data integrity.
• Drives affordability and performance through pre/post-payment reviews and denial management.

Skills

Strategic leadership

Healthcare operations

Claims processing

Regulatory compliance

Process optimization

Education

Bachelor's Degree or equivalent

MBA preferred

Tools

EDI systems

Analytics tools

Job description

SCAN Group is seeking a seasoned executive to lead Claims and Provider Operations in a remote-capable, strategic role. You will shape the operating model, drive cost efficiencies, and ensure regulatory compliance across multiple programs.

You will manage a broad team, align with enterprise goals, and deliver measurable improvements in accuracy, speed, and provider experience while steering a large budget and leveraging AI and analytics.