Director, Operational Excellence

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 300,000 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. 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 Director of Operational Excellence plays a critical role in leading programs and initiatives that drive efficiency, quality, performance, and operational maturity across SCAN's core operational areas. Reporting to the Vice President Operational Excellence, this role collaborates across key functional areas to optimize processes, implement solutions, and deliver results, ensuring exceptional service for members and supporting SCAN's long-term success.

This leader oversees key capabilities focused on quality assurance, compliance and audit readiness, annual readiness, capacity planning, training enablement, knowledge management, measurement, and continuous improvement. The Director identifies high value opportunities to streamline operations, implement best practices, establish scalable, high-performing, and compliant processes.

The ideal candidate brings a builder's mindset, deep health plan operations experience, and a passion for developing high-performing, audit-ready, and member-centered processes.

You Will

Lead development and execution of operational excellence strategies aligned with enterprise goals to optimize workflows and improve service delivery. Identify operational pain points and champion organizational initiatives to improve processes and enhance productivity.

Implement Operational Excellence practices (using lean, six sigma etc.) to drive adoption of standard work, daily management systems, root-cause analysis, and effective problem-solving methods. Serves as expert, apply standardized practices, and implement effective management systems.

Establish and oversee quality assurance and performance monitoring programs tailored to operational areas (i.e., enrollment, claims, provider data management, and grievance & appeals etc.). Enhance quality standards, reduce defects, and maintain compliance with regulatory requirements, ensuring high levels of operational integrity. Establish tools and mechanisms to track, report on performance trends, risks, and improvement outcomes.

Develop and execute SCAN's annual readiness program that ensures business units are prepared to achieve organizational milestones. Own the strategy, planning, coordination, delivery and oversight of cross functional preparedness.

Provide leadership in the resolution of significant operational challenges, overseeing root-cause investigations and the implementation of corrective actions. Foster a proactive problem-solving culture and mitigate risks to ensure consistent and reliable operations.

Develop and implement workforce capacity planning to optimize resource allocation across the organization. Ensure accurate forecasting and monitor performance against capacity plans, adapting strategies as necessary to meet changing business demands and maintain high operational performance.

Serve as a key liaison for compliance and regulatory audits (CMS, DMHC, DHCS, NCQA, state Medicaid agencies); ensure operational areas are consistently audit ready through controls and documentation.

Define and monitor KPIs, audit protocols, and service level expectations to identify gaps and ensure process consistency and effectiveness. Establish tools and mechanisms to track performance trends, risks, and improvement outcomes. Leverage data to make informed recommendations for ongoing improvement and performance enhancement.

Establish a training and knowledge management infrastructure to support onboarding, upskilling, and maintain operational excellence. Maintain and improve SOPs and operational documentation to ensure accuracy and accessibility.

Build and maintain strong relationships with senior leadership, functional leaders, and key stakeholders to drive operational excellence initiatives.

Provide guidance, mentorship, and support to teams across the organization, ensuring alignment on priorities and successful execution of improvement efforts.

Lead and mentor teams fostering a culture of excellence, positive team culture, promote leadership growth, encourage innovation, and continuous learning to achieve team or individual goals. Hire train and coaches' staff.

Supervises/Manages Others (i.e. hires, performance reviews, corrective action, etc.)

We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

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

Other duties as assigned.

Your Qualifications

Bachelor's Degree or equivalent experience in Healthcare administration.

Green Belt certification required.

Graduate or Advanced Degree or equivalent experience preferred.

Expertise in lean, six sigma or similar process improvement methodologies

Black Belt certification preferred.

PMP Certification preferred.

10+ years of experience in healthcare operations management or consulting, preferably in Medicare Advantage plan or

Experience with developing quality assurance program, operational readiness, CMS audit experience.

Managing and leading geographically dispersed teams.

Strong operational management and process improvement skills.

Excellent communication and organizational skills.

Prior use of QI Macros, Minitab software or similar

Lead and inspire teams to achieve goals and drive organizational success
Business Insight - In-Depth understanding of the business

Decision Making and Problem Solving: Effective decision-making and problem-solving skills

Strategic Mindset - Creates strategies to sustain competitive advantage

Planning and Critical Thinking: Strong planning, critical thinking, and leadership skills

Strong understanding of core health plan operational workflows and regulatory requirements.

Excellent communication skills, leadership, and management skills, including executive-level reporting.

Strong analytical and problem-solving skills, with a data-driven approach to decision-making and performance management.

Experience in operational excellence, continuous improvement, and leading large-scale change initiatives within complex organizations using lean, Six Sigma, and other process improvement methodologies.

Ability to build positive relationships with all levels of the organization.

Proficiency in operational analytics, capacity modeling and performance dashboards.

Demonstrated success in audit preparedness and performance improvement initiatives.

Proven ability to lead enterprise-wide initiatives, influence across departments, and build from the ground up. Experience launching new operational programs or functions in a highly regulated environment.

Ability to navigate fast-faced matrixed organization and drive results.

What's in it for you?
* Base salary range: $147,900 to $211,530 per year
* Internal title - Dir Operations
* Work Mode - Mostly Remote
* 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!

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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