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Care Management Initiatives Program Manager II

Job Category:  Clinical
Department:  Care Management
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  6662

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary


The Care Management Initiatives Program Manager II is responsible for leading and managing a portfolio of strategic and transformational Care Management (CM) programs that are generally complex and large in scope. In this capacity, this position will work collaboratively with leadership, management and other stakeholders including Business Owner(s), cross functional teams and participate in administration meetings as appropriate. A key function of this position is to serve as the primary point of contact between care management leadership and the program team, engage all stakeholders and communicate the program’s progress.

 

This position is accountable for working with and facilitating processes to accomplish complex program objectives, managing change, planning, organizing, directing and supervising program activities in a cost effective and productive manner to achieve strategic value and the Care Management vision. This position closely collaborates with business owners, vendors and other organizational staff to understand the business need for each project and makes decisions based on what is best for the organization.

 

This position supports the Care Management initiatives such as Population Health Management ISEIO (Identification, stratification, enrollment/engagement, interventions, and outcomes) for Care Management programs, National Committee on Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), Health Services Advisory Group, Inc. (HSAG) and other audit tools. Specifically the CB-CME start up; MedZed, working with the vendor and CM team; Implementing the field based CM model of care; Palliative Care Program (both adult and pediatric); Population Health Management (PHM 5 Standards) program structure within CM.

 

In addition, this position ensures executive summaries are submitted to leadership for review and approval in a timely manner. Integral to the success of this position is positive interaction with business owners and unit staff, management, third party contractors/vendors, cross-functional team members and other department resources to ensure effective management.

 

This position will be a role model for integrity and will establish and maintain effective professional work relationships, working collaboratively with all levels of management and business owners to help guide the discipline of planning, organizing, securing, managing, leading, and controlling resources to achieve specific goals.

Duties


Critical Thinking & Problem-Solving: Formulate and propose recommended solutions/ options to address moderately complex operational and programmatic challenges in care management , with moderate guidance from director.   

 

Accountability: Assume ownership under direction of director, for successful development, planning, and execution of projects, from initial concept to implementation stage, with moderate guidance and supervision from director. 

 

Relationship building: Maintain strong positive working relationships with internal L.A. Care management staff, in order to facilitate mutual collaboration in strategic and operational efforts to improve quality of care and costs, with moderate guidance and supervision from director.

 

Program Development: Independently lead the design, development and building of program solutions using the ISEIO framework to address Care Management and managed care operational challenges that require collaboration with multiple external stakeholder senior management leaders. Expected to serve as a strategic thought partner with director and senior management leadership team members to advise on strategic programmatic options.

 

Specific Program Responsibilities: Lead the Health Home Program, specifically the CB-CME start up; MedZed, working with the vendor and CM team; Implementing the field based CM model of care; Palliative Care Program (both adult and pediatric); Population Health Management (PHM 5 Standards) program structure within CM.

   

Perform other duties as assigned. 

Education Required

Bachelor's Degree in Health Administration or Related Field
In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Master's Degree in Health Administration or Related Field

Experience


Required:
At least 5-7 years work experience in health care or a related field, doing problem solving, policy, and/or program implementation.

 

Experience building relationships with organizations and business partners.

 

At least one year experience in leading program/project teams.

 

Preferred:
Managed care experience

Skills

Required:
Demonstrated critical thinking, problem solving, and 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.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Additional Information

 

L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)

 

At L.A. Care, we value our team members’ safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.


Nearest Major Market: Los Angeles

Job Segment: Medical, Pediatric, Medicaid, Palliative, Hospice, Healthcare

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