Department(s): Equity and Community Health - Strategic Initiatives
Reports to: Manager, Equity and Community Health- Strategic Initiatives
FLSA status: Non-Exempt
Salary Grade: L - $77,000 - $127,094

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on Wednesday, February 28, 2024 at 11:59 PM. Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.

About CalOptima Health

Are you looking for a career that changes lives? As the single largest health plan in Orange County, CalOptima Health serves one in three residents with health insurance programs for low-income children, adults, seniors and people with disabilities. Our 1,500 employees are valued for their individual perspectives and contributions and benefit from flexible work schedules, recognition and opportunities to grow. If you’re looking for a rewarding career supporting a meaningful mission, along with generous benefits and recognition, consider joining us at CalOptima Health!

About the Position

The Program Manager (PM) - Population Health Management (PHM) Strategic Initiatives plays a vital role in the program design, development, implementation and support of PHM initiatives, pilots and programs related to the National Committee for Quality Assurance (NCQA) Health Plan and Health Equity Accreditations, Department of Health Care Services (DHCS) PHM Strategy and Roadmap and CalOptima Health’s Board of Directors’ PHM priorities. Goals may include helping to close racial/ethnic disparities for identified populations, achieve greater health equity, improve care management and provider resources, as well as assisting with data collection, analysis and reporting. The incumbent will be responsible for coordination, implementation, execution and completion of tasks supporting new program development and the re-design of existing programs. The incumbent will manage cross-functional projects and other assignments in the PHM department, including those related to department efficiency to ensure department strategic objectives and initiatives are met. The incumbent will interact with CalOptima Health’s executives and department management, legal counsel, state and federal regulatory agencies and community stakeholders. The incumbent will also support other CalOptima Health staff on related projects.

Duties & Responsibilities:

• Participates 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.
• Leads program development, implementation of activities and oversight for various PHM programs and project plans including innovative pilots consistent with the DHCS PHM strategy and CalOptima Health’s Board of Directors’ priorities.
• Implements activities supporting the Health Equity enterprise-wide efforts for NCQA, DHCS, Centers for Medicare & Medicaid Services (CMS) and other regulatory agencies as they align with priorities set by leadership. This could include, but is not limited to, supporting CalOptima Health’s Health Equity strategic priorities, collaborating with the Orange County Health Care Agency on their Community Health Assessment and Community Health Improvement Plan processes and supporting community stakeholders’ health equity efforts that align with PHM priorities.
• Assists in the write up and bookmarking of documents used for NCQA Health Equity accreditation and other regulatory agency reporting submissions.
• Coordinates identification and management of data and works with Information Technology Services (ITS), Finance, Enterprise Analytics and Quality Analytics departments to obtain relevant data to strategize and plan.
• Keeps current on the local, state and federal health care environment, identifying issues that may impact CalOptima Health’s medical management programs focused on health equity and social determinants of health.
• Assists with tracking and reporting of Health Equity and SDOH Strategic Plan priorities and tactics.
• Develops recommendations and proposals for leadership consideration.
• Completes other projects and duties as assigned.

Experience and Education:

• Bachelor’s degree in public health, healthcare administration or related field required.
• 3 years of experience in program development, including strategic planning for a start-up program, program implementation and evaluation of evidenced-based programs, preferably in the health care industry or a managed care environment, required.
• 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 and aptitude for working in a highly matrixed, mission-driven organization.

Physical Demands & Work Environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Physical demands: Employee must be able to sit for extended periods of time and work at the computer for long periods. Employee is required to use hands and fingers, especially for typing on the computer and using the mouse. Employee must be able to communicate, particularly for frequent phone use, in meetings and to conduct presentations. Employee must have means of transportation for offsite travel to a local meeting venue as needed.

• Work Environment: Typical office environment with moderate noise levels and controlled office temperatures.

About our Benefits & Wellness options:

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Monday or Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options.

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

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CalOptima Health is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

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If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.

Required Skills

Required Experience

• Ability to work under stressful and emergency situations• Ability to act quickly and accurately• Work well with people• Exhibit manual dexterity• Physical stamina(able to stand, bend, stoop for long periods of time in one location)• Good communication skills