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Manager-Contact Center & Vendor Relations, Member Services

Full-Time

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 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. 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

Effectively manage relationships and contracts with vendors, BPOs, and other business partners to ensure operations run efficiently and compliantly and meets contractual and financial objectives. Ensure service is delivered with a customer first mindset that focuses on a personalized, simplified, and relationship-based member experience. Responsible for collaborating with peers and delivering customer service that exceeds member expectations: going the extra mile, taking the member out of the middle, and WOWing with an enduring service experience.

You will

Vendor Relations/Management:

• Identify, evaluate, and select vendors based on business requirements and company standards.
• Develop and manage relationships with vendors to ensure consistent delivery of quality service and fulfillment of contractual obligations.
• Negotiate favorable terms and conditions with vendors in collaboration with the Procurement team.
• Ensure compliance with company policies and procedures, regulatory and legal requirements, quality standards and service delivery.
• Monitor vendor performance and address any issues or concerns in a timely and effective manner.
• Collaborate with internal teams to identify opportunities for cost savings and process improvements.
• Conduct weekly business reviews and develop action plans to address areas of improvement.
• Support recruitment, onboarding, testing, screening and background verification for contracted vendors and staff.
• Manage the compliance oversight program and reporting under the First-Tier, Downstream, and Related Entities (FDR) requirements.
• Maintain accurate records of vendor contracts, agreements, and communications.

Oversee the performance of multiple teams related to key goals and metrics related to customer service, quality, contact center operations, and compliance. Ensure multi-lingual teams are appropriately monitoring, executing, and resolving against particular member issues as they arise (e.g., grievances, service recoveries, complaints).

Provide strong leadership to your teams through one-on-one communications, team and department meetings, individual coaching, teaching, and evaluating.

Responsible for ensuring teams are delivering excellent service on every interaction with our members.

Encourage employee development through ideation, planning, and execution of activities that foster employee engagement, champions professionalism and civility, and promotes learning and skills enhancement.

Ensures compliance with all regulatory standards including Centers for Medicare and Medicaid Services (CMS), Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS) and HIPAA.

Promote quality by adhering to SCAN’s 5 Star metrics and promoting member activities impacting the quality measures.

Collaboration and Partnering

Collaborate and partner with multiple internal and external stakeholders to ensure the organizations are aligned to provide a world class member experience.

Foster and maintain relationships with third party/external partners and enterprise-wide contacts to improve member experience, remove operational obstacles, convey customer and operational feedback, request, and exchange pertinent data, conduct continuous improvement and coordinate cross-functional initiatives.

Responsible for managing the collaboration efforts with customer service counterparts of our affiliated providers, share operational and strategic customer service metrics/feedback, and the agent experience amongst both SCAN and external resources.

Lead/attend internal and external meetings, participate in and/or facilitate SCAN committees and work groups as requested.

Maintain professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; keeping up to date with industry news and developments; participating in professional societies.

Partner with other departments to respond to and address quality issues related to your membership within appropriate service level agreements.

Partner with Contact Center teams – Training, Quality, Operations, and Workforce Management – to provide input and feedback on how they can help support your teams.

Drive Innovation leveraging Technology and Data

Monitor, discover, assign, and track member experience issues with data driven resolve.

Continuous Improvement to enhance/evolve processes and connectivity with the Member Services model.

Become a SME in utilizing omni-channel contact center technology (e.g., CRM and Telephony technologies) to help drive process efficiencies and a better member experience.

Responsible for preparing compliance and operational reports and metrics pertaining to your teams, including summarizing/analyzing data and trends, and plan for future improvements/corrective action plans.

Measurement of Success

Ultimately you will be measured on the performance of how well your teams manage the membership experience. Performance will be based on key metrics pertaining to members, employees, and partners. Responsible for managing your teams to deliver improvement across these key metrics and effective peer collaboration to meet/exceed departmental goals and metrics.

Actively support the achievement of SCAN’s Vision and Goals.

Other duties as assigned.

Your qualifications

• Required: Bachelor’s degree required, Business, Supply Chain, or Healthcare preferable.
• Preferred, if applicable: Master’s degree Preferred
• A comparable combination of education/experience and/or training will be considered equivalent to the education listed above.
• 5+ years of call center supervisory/management experience required.
• Experience in health care contact center setting – preferred.
• 3+ years of experience in vendor management, procurement, or related field.
• Strong on negotiation, communication, and interpersonal skills.
• Knowledge of contract management and legal terms and conditions.
• Excellent problem-solving and analytical abilities.
• Bilingual Preferred.

What’s in it for you?

• Base salary range: $80,300.00- $128,500.00 Annually
• 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
• Robust employee recognition program
• Tuition reimbursement
• A work-life balance
• An opportunity to become part of a team that makes a difference to our members and our community every day!

Covid-19 Vaccination Policy

To ensure a healthy and safe work environment, if you are selected for this position, your job offer with SCAN Health will be contingent upon being fully vaccinated and providing proof of your COVID-19 vaccine within 3 days after your start date. Generally, you are considered fully vaccinated 14 days after receiving the last dose, as recommended by the manufacturer, of a vaccine that has been authorized by the FDA for use in the United States, including vaccinations that have been approved pursuant to an Emergency Use Authorization. If fully vaccinated outside of the United States, the vaccination must be listed for emergency use by the World Health Organization (WHO). If you cannot receive the vaccine because of a disability/medical reason or sincerely-held religious belief, you may request an accommodation to this requirement by contacting COVID-19 Vaccination Policy. Learn more about the COVID-19 vaccination here - https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html

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. #LI-JR1

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)