The role manages the end-to-end sales commission process and provides analytics on incentive compensation plans. It involves auditing data for accuracy, resolving payment discrepancies, and partnering with Finance and HR to optimize sales performance.
SCAN Health Insurance
18 Remote Job Openings at SCAN Health Insurance
Network Management Implementation Specialist
SCAN Health Insurance
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Full Time
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10 days ago
SCAN Health Insurance
Manage the end-to-end onboarding and offboarding processes for contracted medical groups and providers to ensure a seamless transition. Coordinate cross-functional tasks, maintain operational workflows, and support system modernization efforts to improve provider experience and data integrity.
Manager, Pharmacy Experience and Access
SCAN Health Insurance
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Full Time
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14 days ago
SCAN Health Insurance
Oversee the design and implementation of the Part D program, ensuring CMS compliance and operational excellence for a senior-focused Medicare Advantage Plan. Manage the contracted pharmacy benefit manager (PBM) and lead the Pharmacy Experience & Access team to optimize member experience and clinical operations.
Senior End User Support Specialist
SCAN Health Insurance
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Full Time
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15 days ago
SCAN Health Insurance
Provide high-level technical support and troubleshooting for software and hardware while acting as a bridge between Help Desk Technicians and Infrastructure Engineering. Manage workflow for Help Desk staff and handle escalated technical issues to ensure customer satisfaction.
Director, Special Investigations Unit - AHFI
SCAN Health Insurance
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Full Time
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25 days ago
SCAN Health Insurance
Lead the development and execution of the Special Investigations Unit (SIU) infrastructure to manage fraud, waste, and abuse (FWA) programs. Oversee complex investigative cases, ensure regulatory compliance, and collaborate with legal and internal audit teams to implement recovery efforts.
Serve as a primary point of contact for members regarding benefits, eligibility, claims, and referrals. Ensure member satisfaction by providing quality customer service and resolving issues in a timely and professional manner.
Act as a front-line contact center agent providing personalized support and resolving healthcare administrative issues for members. Coordinate with internal and external stakeholders to ensure timely resolution of member concerns and maintain detailed interaction records.
Medical Management Specialist, LVN
SCAN Health Insurance
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Full Time
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a month ago
SCAN Health Insurance
The Medical Management Specialist-LVN supports utilization management processes to ensure the medical necessity and cost-effectiveness of care for members. This includes conducting pre-service and concurrent reviews, managing complex medical cases, and coordinating safe discharges from inpatient settings.
Medical Management Specialist, LVN
SCAN Health Insurance
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Full Time
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a month ago
SCAN Health Insurance
The Medical Management Specialist-LVN supports utilization management processes to ensure the medical necessity and cost-effectiveness of care for members. This includes conducting pre-service and concurrent reviews, managing complex medical cases, and coordinating safe discharges from inpatient settings.
Telesales Representative - SCAN Temp
SCAN Health Insurance
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Full Time
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a month ago
SCAN Health Insurance
Facilitate telephonic enrollment for health plans by presenting benefit information and verifying Medicare/Medi-Cal eligibility. Support field sales by scheduling appointments and conducting follow-up welcome calls to prospective members.
Quality Auditor - Health Plan Operations
SCAN Health Insurance
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Full Time
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2 months ago
SCAN Health Insurance
Perform routine and targeted operational quality audits across health plan operations to ensure compliance with regulatory requirements and internal policies. Monitor accuracy and identify improvement opportunities to enhance the member and provider experience.
Serve as the primary point of contact for members regarding benefits, eligibility, claims, and referrals. Ensure member satisfaction by providing quality customer service and resolving issues efficiently while adhering to regulatory guidelines.
Marketing Analytics Analyst, Sr.
SCAN Health Insurance
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Full Time
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2 months ago
SCAN Health Insurance
Responsible for creating marketing data strategies and implementing reports to optimize budget, spend, and campaign performance. The role involves collaborating with cross-functional teams to provide actionable insights for customer acquisition and retention.
Acts as a primary point of contact for members to resolve questions regarding benefits, eligibility, claims, and referrals. Ensures member satisfaction by providing high-quality customer service and coordinating resolutions with providers and internal departments.
Lead the pharmacy operations team to ensure regulatory compliance with CMS and other state requirements regarding prescription drug benefits. Oversee PBM operations, manage Part D reporting, and drive departmental goals through cross-functional collaboration.
Broker Account Executive (Houston, TX)
SCAN Health Insurance
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Full Time
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3 months ago
SCAN Health Insurance
The Broker Account Executive is responsible for overseeing, training, and servicing the broker distribution channel to achieve sales targets for Medicare Advantage plans. This role involves maintaining relationships with agencies, ensuring regulatory compliance, and coordinating broker education and marketing campaigns.
This role is responsible for analyzing performance data within the Medicare Advantage STAR Program, supporting quality improvement initiatives, managing measure-level interventions, and ensuring the organization meets CMS STAR rating goals. The analyst will monitor, analyze, and develop insights on various STAR measures, perform root-cause analysis, and collaborate across departments to design and implement quality improvement strategies.
Sr. Claims Resolution Analyst
SCAN Health Insurance
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Full Time
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4 months ago
SCAN Health Insurance
Senior Claims Resolution Analysts are responsible for investigating and resolving complex insurance claims by analyzing data, reviewing policies, communicating with stakeholders, and negotiating settlements. They may also mentor junior staff, guide difficult cases, and assist with process improvement initiatives.
