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 270,000 members in California, Arizona, and Nevada. 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.
The Job
Support SCAN’s value-based partnerships and care delivery efforts with medical groups, independent provider associations (IPAs), hospitals, and integrated delivery systems in this rapidly growing area. Working on a diverse range of projects, leverage clinical and pharmacy claims, demographic, authorizations, and care management data to evaluate financial risk, identify medical economic trends, and assess the performance of clinical programs for quality and financial outcomes. Focus on medical economics, utilization management, care standards variation analysis, and key performance indicator and executive reporting. In collaboration with value-based care leaders, insights will directly contribute to the overall strategy and expansion key objectives.
You Will
Essential Key Job Responsibilities
- Serve as subject matter expert (SME) and thought leader for care delivery analytics and value-based care/shared risk utilization management analytics methodological and business case questions
- Maintain, enhance, and build reports and dashboards that connect insights to business impacts, and propose actionable strategies to partners and leaders through quick updates and prepared presentations using storytelling and data visualizations
- Research, evaluate and deploy new tools, frameworks and patterns, including identification of gaps and opportunities for improvement of current care delivery businesses.
- Deliver performance reporting to partners and stakeholders, effectively communicating findings and making recommendations for continuous improvement
- Maintain knowledge of operations sufficient to identify causative factors, deviations, allowances that may affect reporting findings
- In conjunction with payer strategy/network management, develop financial models to support optimization, negotiation and expansion of value-based care and shared risk arrangements
- Lead and coordinate standard and ad hoc analytics projects through various complex and challenging situations to completion under time-sensitive deadlines, including review and QA of work of other team members
- Ensure continuous improvement in analytics deliverables and insights that ‘break new ground’
- Develop and maintain technical specifications and end-user documentation for assigned projects and analyses
Essential Partnerships and Attributes
- Interface with SCAN value-based care, direct care delivery, risk adjustment, finance and network management and other cross functional areas
- Build relationships with central analytics teams which add value to the organization by reducing silos
- Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies
Actively support the achievement of SCAN’s Vision and Goals.
Other duties as assigned.
Your Qualifications
- Bachelor’s or Master’s Degree in Data Science, Statistics, or Business or Healthcare Administration, preferred.
- 3-5 years of experience in care delivery analytics and/or healthcare data analysis
- 2-3 years of leadership experience
- Track record of successful engagement with partners and stakeholders in value-based healthcare models
- Direct experience in Medicare, care management, or utilization management analytics at a health plan
- Proficiency in SQL, Microsoft SSMS, R, Python, SAS, and dashboard tools such as Tableau; Alteryx and Databricks experience preferred.
- Advanced understanding of healthcare informatics and medical economics (i.e. ICD, CPT, Rev codes, PMPM, utilization rates, case mix, attribution methods, risk adjustment, evidence based or quality metrics, risk segmentation and modeling, clinical episode groupers and other advanced clinical informative software to measure cost and quality of care).
- Excellent communication skills, both oral and written, with the ability to provide formal reports for leadership at all levels.
- Experience navigating and contributing in a matrix environment, with prior corporate experience preferred.
What’s in it for you?
- Base salary range: $106,200.00 to 169,900.00 annually
- Work Mode: Remote
- An annual employee bonus program
- Robust Wellness Program
- Generous paid-time-off (PTO)
- Eleven paid holidays per year, plus 1 additional floating 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!
We’re always looking for talented people to join our team! APPLY HERE