Care Management Initiatives Program Manager II

L.A. Care Health Plan•Los Angeles, CA

4d•$102,183 - $163,492

About The Position

The Care Management Initiatives Program Manager II leads and manages a portfolio of strategic Care Management programs that are generally complex and large in scope. The role works with leadership, management, cross-functional teams, regulatory representatives, vendors, business owners, and other stakeholders, serving as a primary point of contact between Care Management leadership and other program teams and communicating relevant updates. The position facilitates processes to accomplish complex program objectives and manages change, planning, organizing, directing, and supervising program activities in support of strategic goals and the Care Management vision. It works with organizational partners to understand business needs and make decisions in the best interests of the department and organization. The role supports development and implementation of Care Management initiatives to meet regulatory and accreditation requirements, including requirements in contracts, memorandums of understanding, CalAIM Policy Guides, NCQA PHM, DHCS All Plan Letters, and CMS Model of Care. It maintains effective professional relationships, collaborates across levels of management and with business owners, and oversees day-to-day operations of related programs and activities.

Requirements

Bachelor's degree in Public Health or a related field; equivalent education and/or experience may be considered in lieu of a degree.
At least 5 years of work experience in health care or a related field involving policy and/or program implementation.
Experience building relationships with organizations and business partners.
At least 1 year of experience leading program or project teams.
Demonstrated critical-thinking, problem-solving, program-planning, and implementation skills.
Demonstrated strong writing and communication skills.
Demonstrated ability to synthesize and analyze qualitative and/or quantitative data.
Knowledge of health care operations or health care systems.

Nice To Haves

Master's degree in Public Health or a related field.
Managed care experience.
Project Management Professional (PMP) certification.

Responsibilities

Formulate and propose solutions to moderately complex operational and programmatic challenges in Care Management, with moderate guidance from Care Management leadership.
Take ownership, under the direction of the department Director or Senior Director, of project development, planning, and execution from initial concept through implementation.
Maintain positive working relationships with internal L.A. Care Management staff to support collaboration on strategic and operational efforts to improve care quality and program effectiveness.
Independently lead the design, development, and enhancement of program solutions addressing Care Management operational challenges, collaborating with external stakeholders and senior management.
Advise the Director, Senior Director, and senior management or leadership team on strategic program options and regulatory and accreditation compliance.
As applicable, prepare executive summaries comparing new policies and regulatory requirements with program compliance for timely leadership review and approval.
Oversee and administer day-to-day operations of related programs and activities.
Perform other duties as assigned.