Senior Program Manager

COPE Health Solutions • Los Angeles, CA

1d • $80,000 - $90,000 • Onsite

About The Position

COPE Health Solutions is a national tech-enabled services firm powering success for health plans and for providers in risk arrangements. Our comprehensive NCQA certified population health management platform and highly experienced team brings deep expertise, experience, proven tools, and processes to improve financial performance and quality outcomes for all types of payers and providers. CHS de-risks the roadmap to advanced value-based payment and improves quality and financial performance for providers, health plans and self-insured employers. For more information, visit CopeHealthSolutions.com.

Requirements

• Bachelor’s degree in health administration, Public Health, Nursing, Social Work, or related field required.
• Proven experience in managing complex programs.
• minimum of 5 years of leadership or supervisory experience in managed care.
• Strong understanding of Population health and complex care management.
• Experience with quality metrics, performance reporting, and data analysis.
• Exceptional leadership, strategic thinking, risk management, and communication skills.
• Excellent written and verbal communication skills
• Ability to collaborate across departments and with external stakeholders.
• Proficiency in electronic documentation and reporting systems.

Nice To Haves

• Master’s degree or project management certification (e.g., PMP) preferred.
• Experience working with Medi-Cal or managed care population preferred.
• Knowledge of ECM Model of Care strongly preferred.

Responsibilities

• Strategic Planning & Execution: Execute comprehensive program strategies, roadmaps, and detailed project plans to achieve business goals.
• Develop and execute initiatives to improve enrollment, engagement, and retention.
• Cross-Functional Leadership: Leads teams across various locations, managing resources, and ensuring collaborative execution.
• Risk Mitigation & Quality Control: Proactively identifies risks, develops mitigation plans, and maintains quality standards.
• Identify growth opportunities and support program expansion efforts.
• Budget & Resource Management: Oversee program budgets, financial forecasting, and resource allocation to ensure profitability and efficiency.
• Monitor enrollment trends, billing, and revenue cycle performance.
• Ensure program sustainability through performance monitoring and financial oversight.
• Stakeholder Communication: Reports on development progress, providing updates to executive leadership and key stakeholders.
• Serve as a liaison with contracted health plans and external partners.
• Participate in joint operational committee (JOC) meetings and performance reviews.
• Process Improvement: Analyzes performance metrics to identify areas for improvement and implements best practices.
• Direct the implementation and ongoing management of the ECM Program
• Operational Oversight: Supervise program managers and interdisciplinary care teams.
• Develop, implement, and refine workflows, policies, and standard operating procedures. Ensure accurate and timely documentation on required platforms.
• Maintain audit readiness and respond to internal and external audits.
• Compliance and Regulatory Oversight: Ensure adherence to DHCS ECM requirements and Medi-Cal regulations.
• Oversee documentation standards and compliance practices.
• Leaf team during MCP and State audits.
• Provide leadership in reporting audit results and outcomes.

Benefits

• As a firm passionate about health care, we’re deeply committed to the health and wellness of our own team members. We offer comprehensive, affordable insurance plans for our team and their families, and a host of other unique benefits, such as a yearly stipend for wellness-related activities and a paid parental leave program. You can learn more about our benefits offerings here: https://copehealthsolutions.com/careers/why-cope-health-solutions/.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level