Managed Care Program Manager, Operations & Delegation Oversight
About The Position
The Program Manager of Health Plan Delegation Oversight is a strategic leader with expertise in change management, process improvement, and operational strategy, ensuring compliance and enhancing Health Plan operations. This role involves overseeing delegated functions for AHN’s Restricted Knox-Keene licensed Medi-Cal Health Plans, with a focus on managing corrective action plans (CAPs) and mitigating compliance risks. The Manager collaborates with cross-functional teams to improve monitoring processes, ensuring alignment with regulatory agencies like DHCS, DMHC, and CMS. They lead efforts to identify performance risks, implement process improvements, and drive continuous enhancements to sustain compliance and operational efficiency across delegated functions.
Requirements
- Bachelor’s degree in Healthcare Management, Public Health, Business, Health Administration, or related field required or 5 years of relevant experience.
- Minimum of 5 years of healthcare experience in designing and implementing compliance programs, focusing on Medicaid/Medi-Cal plans and regulatory adherence.
- Minimum of 5 years of experience in healthcare consulting, delivering scalable solutions in dynamic environments, and recognized as a strong collaborator across teams and functions.
- Experience in creating executive reports and analyzing data with tools like Microsoft Office, SharePoint, Smartsheet, Tableau, and Alteryx.
Nice To Haves
- Master's Degree in Healthcare Management, Public Health, Business, Health Administration, or related field preferred.
Benefits
- Medical, Dental and Vision insurance
- 403(b) Retirement savings plans with employer matching contributions
- Flexible Spending Accounts
- Commuter Flexible Spending
- Career Advancement & Development opportunities
- Paid Time Off & Holidays
- Paid CME Days
- Malpractice insurance and tail coverage
- Tuition Reimbursement Program
- Corporate Employee Discounts
- Employee Referral Bonus Program
- Pet Care Insurance
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What This Job Offers
Job Type
Full-time
Career Level
Manager
