CalOptima Health is seeking a highly motivated an experienced Program Manager (Operations) to join our team. Under the general direction of the Supervisor Quality Analytics, the Program Manager (Operations) will collaborate and coordinate with leadership to design, implement and evaluate quality programs. The incumbent will lead, coordinate, monitor and complete tasks supporting the development of quality programs and initiatives. The incumbent will monitor cross functional projects and other assignments, including those relating to department efficiency to ensure department strategic objectives and initiatives are met. The incumbent will interact with CalOptima Health’s executives and management, legal counsel and state and federal regulatory agencies. Additionally, the incumbent will support CalOptima Health staff on related projects as needed.
- Department : Quality Analytics
- Salary Grade : 311 - $77,863 - $124,581 ($37.43 - $59.8947)
- Work Arrangement : Partial Telework
- This position is eligible for telework in California.
Duties & Responsibilities :
80% - Program ManagementLeads program development, execution of activities and oversight of campaigns executed through vendors such as text messages, robocalls and member health rewards program.Tracks and monitors the impact and success of programs.Assists management in the development of specifications and scope of work for a Request for Proposal (RFP), Request for Quote (RFQ) or Request for Inquiry (RFI) to support new program development.Collaborates with other departments on program design, development and implementation of quality programs impacting, but not limited to, Healthcare Effectiveness Data and Information Set (HEDIS), Managed Care Accountability Sets (MCAS) and Centers for Medicare & Medicaid Services (CMS) STARs quality measures; ensures consistency with the quality program and workplan.Supports National Committee for Quality Assurance (NCQA) accreditation standard initiatives or projects and provides analysis and evaluation of related activities as needed.Produces documentation, summaries, root cause analyses, impact analyses and reports for department operations, audits, and responses to regulators.Reviews evidence-based literature for best practices to incorporate into strategy.Develops and oversees the process of written tools for programmatic use, including program plans, surveys and evaluation instruments.Collaborates with other departments in the development of program measures of success and outcome reports for programs.Maintains current knowledge of applicable regulations or clinical guidelines related to program development.Stays current on the local, state and federal health care environment and identifies issues that may impact CalOptima Health’s quality program and workplan.15% - Administration SupportParticipates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals / priorities for the department.Reviews and assists in updating policies and procedures to ensure knowledge related to assigned programs and projects is kept up-to-date.Works with all CalOptima Health departments in response to inquiries, problem-solving and promoting CalOptima Health’s mission and message.5% - Completes other projects and duties as assigned.Minimum Qualifications :
Bachelor’s degree required PLUS 3 years of related work experience in program development and / or data analysis is required, preferably in the health care industry or a managed care environment; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.Preferred Qualifications :
Master’s degree in public health, health administration or related field.1 year of experience working in a highly matrixed, mission-driven organization.Required Licensure / Certifications :
N / AKnowledge & Abilities :
Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.Work independently and exercise sound judgment.Communicate clearly and concisely, both orally and in writing.Work a flexible schedule; available to participate in evening and weekend events.Organize, be analytical, problem-solve and possess project management skills.Work in a fast-paced environment and in an efficient manner.Manage multiple projects and identify opportunities for internal and external collaboration.Motivate and lead multi-program teams and external committees / coalitions.Utilize computer and appropriate software (e.g., Microsoft Office : Word, Outlook, Excel, PowerPoint) and job specific applications / systems to produce correspondence, charts, spreadsheets, and / or other information applicable to the position assignment.Physical Requirements (With or Without Accommodations) :
Ability to visually read information from computer screens, forms and other printed materials and information.Ability to speak (enunciate) clearly in conversation and general communication.Hearing ability for verbal communication / conversation / responses via telephone, telephone systems, and face-to-face interactions.Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.Lifting and moving objects, patients and / or equipment 10 to 25 poundsWork Environment :
If located at the 500, 505 Building or a remote work location :
Work is typically indoors and sedentary and is subject to schedule changes and / or variable work hours, with travel as needed.There are no harmful environmental conditions present for this job.The noise level in this work environment is usually moderate.If located at PACE :
Work is typically indoors in a clinical setting serving the frail and elderly.There may be harmful or hazardous environmental conditions present for this job.The noise level in this work environment is usually moderate to loud.If located in the Community :
Work is typically indoors and sedentary and is subject to schedule changes and / or variable work hours, with travel as needed.Employee will occasionally work outdoors in varied temperatures.There may be harmful or hazardous environmental conditions present for this job.The noise level in this work environment is usually moderate to loud.To apply and for the full job description please visit : https : / / apptrkr.com / 5878683
Salary : $77,863 - $311,000
