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.Oversee daily operations and activities performed by non-clinical staff, including Prior Authorization, Hospital Notification, and Concurrent Review support, to ensure the provision of appropriate utilization of services and efficient and quality service to members and providers.You WillSupervise and coordinate day-to-day operations of the Medical Management department non-licensed staffDemonstrate oversight of the authorization process, hospital notification and census managementComplete quality review and auditing to ensure compliance with all regulatory and compliance standardsSupport ongoing department process improvements through the PDSA practice by timely communication and education to the teamEnsures staff success by timely communication of job expectations and monitoring of goal progress by coaching and counseling employees; initiating, coordinating, and enforcing systems, policies, and proceduresMaintain staff by recruiting, selecting, orienting, and training employees; maintaining a safe and secure work environment; developing personal growth opportunitiesBuild effective professional relationships with providers and other internal and external partners by using excellent verbal and written communication skills, developing trust, meeting timelines,respecting cultural differences, using active listening skills, and maintaining confidentialityPromote compliance with and adheres to all regulatory and quality standards including but not limited to: Centers for Medicare and Medicaid Services (CMS), Department of Managed HealthCare (DMHC), Department of Health Care Services (DHCS), and accreditation bodies’ standards such as the National Committee for Quality Assurance (NCQA) as it relates to MedicalManagement's activitiesSupervisory Responsibilities 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 QualificationsAssociate's Degree or equivalent experience2-3 years of related experience in a Medicare Advantage Health Plan Utilization ManagementAt least 1 year of leadership experienceKnowledge of the field's policies, procedures, and practicesLeads and directs the work of other employeesLeadership - Basic skills to develops othersProblem Solving - Basic problem-solving skillsCommunication - Good communication and interpersonal skillWhat's in it for you?Base salary range: $70,304 to $84,143 per yearWork Mode: Mostly RemoteAn annual employee bonus programRobust Wellness ProgramGenerous paid-time-off (PTO)11 paid holidays per year, plus 1 floating holiday, plus 1 birthday holidayExcellent 401(k) Retirement Saving Plan with employer match and contributionRobust 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-CS2#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