Program Manager, Cost of Care

SCAN Group; Long Beach (CA); Remote; USD 92,000 - 148,000; Full time

Job summary

An established industry player is seeking a Program Manager to lead cost-management initiatives aimed at enhancing healthcare for seniors. This role involves strategic problem-solving and data analysis to drive cost-saving strategies while ensuring high-quality outcomes for members. Collaborating with various departments, you will monitor performance metrics and present actionable insights to leadership. Join a mission-driven organization that values innovation and supports the well-being of older adults, while offering a flexible work environment and numerous employee benefits.

Benefits

Annual employee bonus program

Robust Wellness Program

Generous paid-time-off (PTO)

Eleven paid holidays plus floating holiday

401(k) Retirement Saving Plan with employer match

Employee recognition program

Tuition reimbursement

Opportunity to make a difference

Qualifications

• 5 years of experience in provider performance management.
• Previous experience in health plan or ACO managing cost of care trends.

Responsibilities

• Analyze cost of care trends to identify cost drivers and opportunities.
• Develop cost-saving strategies and manage value-based provider contracts.

Skills

Analytic Skills

Quantitative Skills

Problem-solving Skills

Verbal Communication

Written Communication

Education

Bachelor's Degree

Equivalent Experience

Job description

Join to apply for the Program Manager, Cost of Care role at SCAN.

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.

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

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. Prepares and presents program reports: Creates detailed reports and presentations for stakeholders, summarizing program impacts, cost trends, and strategic recommendations to address plan challenges.
8. 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.
9. 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.
• Strong Analytic, Quantitative, And Problem-solving Skills Required.
• Strong verbal and written communication skills required.

What's in it for you?

• Base salary range: $92,400 to $147,800 per year.
• Internal Title: Program Manager.
• Mostly 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!

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.

Seniority level

• Mid-Senior level

Employment type

• Full-time

Job function

• Project Management and Information Technology
• Industries: Hospitals and Health Care