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.
The Job
The Manager Grievances, Appeals, and Complaints leads the strategic oversight and daily operations of the organization's grievance, appeal and complaint program, ensuring all cases are resolved in a timely, fair, and compliant manner that upholds regulatory standards and exceeds member expectations.
This role is accountable for managing dedicated teams, driving continuous process improvement across cross-functional departments, mitigating regulatory and operational risk, and maintaining the highest standards of transparency, fairness, and customer service. By aligning grievance, appeal and complaint processes with evolving federal and state regulatory requirements, the Manager safeguards organizational compliance while enhancing member satisfaction and operational efficiency.
You Will
Strategic Department Leadership: Lead, manage, and oversee the day-to-day operations and productivity of the Grievance and Appeals Department, ensuring alignment with organizational goals, vision, and strategic objectives while maintaining high-volume case throughput and service level agreements.
Regulatory Compliance Management: Ensure full compliance with all applicable federal and state regulatory standards, including but not limited to CMS (Medicare Part C and Part D), DMHC, DHCS, and other governing bodies, by establishing processes for ongoing monitoring, staff training, and proactive remediation of identified non-compliance areas.
Workflow and Process Optimization: Develop, implement, and continuously improve workflows, systems, tools, and monitoring processes to ensure timely completion of all grievance, appeal, and complaint functions within required regulatory timeframes, driving operational efficiency and quality outcomes.
Team Management and Staff Development: Recruit, select, orient, train, and develop department staff, acting as the first-line resource for problem-solving and performance management, ensuring proper staffing levels (including temporary staffing), and fostering a culture of teamwork, accountability, and professional growth.
Cross-Functional Stakeholder Collaboration: Partner with cross-functional teams across legal, compliance, customer service, operations, and clinical leadership to address complex grievance and appeal issues, resolve escalations, and drive integrated process improvements that align with organizational priorities.
Data Analytics and Executive Reporting: Develop, analyze, and present department metric reporting on productivity, efficacy, and compliance trends to senior leadership, conducting root cause analysis for recurring issues and developing data-driven action plans to prevent recurrence and improve outcomes.
Strategic Policy Recommendations: Analyze grievance and appeal trends, recurring issues, and regulatory developments…