Business Process Owner

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 285,000 members in California, Arizona, Nevada, 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 www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn; Facebook; and Twitter.

The Job

The Business Process Owner (BPO) will be responsible for managing the Network Operations & Provider Services Business Rules & Requirements. The BOP works directly with internal teams to identify, develop and translate business requirements and workflows. The Business Process Owner is also expected to serve as an intermediary among stakeholders, with the purpose of soliciting, analyzing, and validating requirements for modifications to business processes, policies, and information systems.

You Will

• Functions as Subject Matter Expert (SME) for Network Operations & Provider Services department.
• Collaborates with IT and Operations team to understand and translate business requirements.
• Lead and assist with developing comprehensive test plans/ test scripts/ test data and completion of comprehensive testing of changes, enhancements and issue remediation.
• Assists in the facilitation of internal meetings and the prioritization of work.
• Translates business requirements between technical and non- technical audiences in verbal and written formats.
• Identifies opportunities for process improvements, meeting with necessary parties to gather requirements and creates supporting documentation to include requirements, analysis outcome and recommendations. Oversee the lifecycle of the process, from design to execution, monitoring, and optimization.
• Builds strong collaborative relationships internally at SCAN between technical teams, Shared Services, Network Management, Member Services, Claims and all other business units.
• Serve as an intermediary among stakeholders, with the purpose of soliciting, analyzing, and validating requirements for modifications to business processes, policies, and information systems.
• Works closely with Business Analyst/User Tester on testing efforts and business process documentation.
• Knowledge and experience working in SAFe Agile framework with knowledge and participation in various scrum ceremonies, collaborating with multiple IT team members and business product owners, product managers and business owners.
• All other duties as assigned

Your Qualifications

• Bachelor's Degree or equivalent experience
• 2-3 years of experience working in health care provider operations, or equivalent experience with credentialing, claims, and provider data management.
• Understanding of CMS 1500 and UB-04 Claim Form, National Provider Identifier (NPI), and provider set up requirements such as excluded and optout provider settings.
• Ability to prioritize tasks and meet deadlines with minimal supervision.
• Superior analytic, quantitative, problem-solving, critical thinking, and decision-making skills.
• Strong verbal and written communication skills.
• Knowledge of Access database and basic SQL preferred.
• Superior analytic, quantitative, problem-solving, critical thinking, and decision-making skills.
• Strong interpersonal skills, including excellent written and oral communication skills.
• Strong organizational skills. Ability to multitask.
• Ability to be flexible and adjust in a fast-paced and dynamic environment.

What's in it for you?

• Base Pay Range: $71,700 - 114,700 Annually
• Work Mode: Remote
• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• 11 paid holidays per year, plus 1 additional floating holiday
• Excellent 401(k) Retirement Saving Plan with employer match
• 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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Salary : $71,700 - $114,700