Director, Provider Data Operations

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.About SCANSCAN 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, New Mexico, Washington and Texas. 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 or follow us on LinkedIn; Facebook; and Twitter.The JobThe Director, Provider Data Operations ensures provider information is accurate, complete, timely, governed, and trusted across the enterprise. This role is responsible for the evolution of a single source of truth for provider data and enables downstream operational, regulatory, network, member-facing, and provider-facing processes with reliable provider intelligence. The Director will work cross functionally driving continuous improvement, AI-enabled automation, data quality controls, and governance practices that strengthen provider data accuracy, reduce manual effort, improve workflow efficiency, and increase confidence in internal and external provider directories.You WillLeads end-to-end provider data operations, including provider hierarchy, provider records, verification, roster management, reconciliation, delegated oversight, audit readiness, issue resolution, and continuous improvement.Owns provider data accuracy and directory integrity by establishing quality standards, validation controls, audit processes, and root-cause resolution to prevent recurring data defects. Responsible for data accuracy on internal and external provider directories.Drives strategy and governance for provider data as a trusted enterprise source of truth, including policies, procedures, business rules, data stewardship, and alignment with downstream systems and workflows. Contributes to planning, direction, and goal setting for the department or function in collaboration with senior management.Ensures regulatory and business readiness by maintaining controls that support CMS and state requirements, network adequacy, provider directory accuracy, product participation, provider terminations, and delegated oversight.Understands and implement new and future compliance requirements. Supports critical business strategies by providing systematic solutions and/or recommendations on business processes. Proficient in navigating legislative changes, federal and state regulations, to direct teams to make necessary changes.Directs small and medium projects and initiatives. Define and deliver initiatives according to agreed-upon business requirements and timelines.Partners across Operations, Technology, Network Management, Compliance, Product, Digital, vendors, and delegated provider groups to integrate, govern, and improve provider data across enterprise processes.Leads implementation, optimization, and oversight of provider data applications, vendor solutions, automation, and AI-enabled capabilities that improve accuracy, efficiency, workflow performance, and decision-making.Monitors performance against KPIs, SLAs, quality measures, and risk indicators; translate trends into actionable insights, recommendations, and operational action plans. Proactively identifies opportunities for process improvements.Establishes departmental policies, practices, and procedures that have a significant impact on the organization. Oversee the creation of document workflows and policies and procedures (P&Ps) as necessary.Builds and develop a high-performing team by setting clear goals, accountability standards, training expectations, and a culture of service, innovation, continuous improvement, and data stewardship.Establishes staffing needs and ensure consistent training for staff through adoption of standardized processes.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 QualificationsBachelor's Degree or 5+ years equivalent work experience;2+ years of leadership experience2+ years in leading Provider Data Management teams at managed care provider organization (IPA, Medical Group or institutional provider) or insurance company5+ years of overall Healthcare experience.What's in it for you?Base Pay Range: $147,900-$205,000, SalaryWork Mode: RemoteAn annual employee bonus programRobust Wellness ProgramGenerous paid-time-off (PTO)11 paid holidays per year, 1 floating holiday, birthday off, and 2 volunteer daysExcellent 401(k) Retirement Saving Plan with employer matchRobust employee recognition programTuition reimbursementAn 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.#LI-JK1#LI-HybridEqual Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe 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) #J-18808-Ljbffr Scan-Health-Plan