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Enterprise and Network Oversight Program Manager III

Job Category:  Administrative, HR, Business Professionals
Department:  Enterprise Performance Optimization
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  8732

 

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.

As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.

Job Summary

The Enterprise and Network Oversight Program Manager (PM) III is an integral part of ensuring the success of the Enterprise Performance Optimization  Program (Enterprise POP) and the Network Performance Optimization Program (Network POP). The PM is responsible for developing and maintaining the processes and artifacts used to support departmental programs and initiatives. The PM collaborates with EPO Leadership,  internal stakeholders, and vendors to facilitate the delivery of EPO's Programs, with appropriate governance and validation to ensure all program components are stood up with appropriate quality assurance, methods, and data validation. The PM designs and/or enhances the process and the tools needed to aggregate, digest, and validate all applicable federal, state, regulatory, sub-regulatory, and contractual requirements, accreditation standards, and policy into performance criteria, and identifies implements opportunities for automation to create efficiencies. The PM leads the design and maintains the attestation process and platform, in collaboration with key stakeholders and vendors, and trains stakeholders to ensure successful adoption. The PM leads the implementation of all change management processes to keep the performance criteria and Programs materials up-to-date. The PM supports strategic plans and programs designed to achieve the Department's business goals and objectives, and leads initiatives that optimize Plan and Network performance. On a project-by-project basis, the PM delineates an appropriate scope tailored to achieve the project's goals, creates and runs a program plan and timeline, engages internal and external stakeholders, as needed, and provides the logistical support and subject matter expertise needed to successfully complete the program. The PM assembles and delivers all protocols, manuals, and training to ensure EPO staff and stakeholders are apprised of the methods and processes implemented in the Programs and other departmental initiatives and programs.

Duties

Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the program's deliverables meets the needs of the department, organization and legislation's policies, standards, and best practices.  

Oversees the Plan and Network performance,  processes and systems by which those performance criteria are deployed in the programs in the form of qualitative or quantitative metrics. Monitors progress of department initiatives and projects, and identifies roadblocks. Collaborates and negotiates cross-functionally, with multiple stakeholders to problem solve, to resolve issues, and to meet deadlines. Performs risk management analyses,  regulatory, sub-regulatory, contractual and accreditation standards research related to EPO programs, and evaluates their impact to the department's operations and  initiatives.

Actively engages in the  establishment and oversight of the development and maintenance of Key Performance Indicators (KPIs or Metrics) by developing processes and mechanisms by which Department management can systematically assess, track and trend internal L.A. Care performance, external delegate performance, and acts as the central resource for Department management to strengthen process and data integrity.   Builds and maintains a change management system for the EPO and NPO programs to respond to changes in legal, regulatory, contractual and operational changes while maintaining the integrity of the programs and the underlying data and information.  Monitors operational deficiencies identified through the Department's Programs, projects, and initiatives and ensures appropriate escalation.

Acts as a liaison between EPO and internal stakeholders in the development of a full inventory of program solutions and initiatives, including, but not limited to, the Enterprise POP and Network POP programs. Builds and maintains, and engages cross-functionally with others to build and maintain, the tools and infrastructure necessary for the proper functioning and updating of departmental programs, including the Enterprise POP and Network POP programs.

Education Required

Bachelor's Degree
In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Master's Degree
Juris Doctor Degree or Doctor of Law Degree (J.D.)

Experience

Required:
At least 5-7 years of data analysis and reporting, experience with at least 3 of project or program management  in a health plan or managed care setting in Operations and Regulatory Compliance.

Direct experience with the Software Development Life Cycle (SDLC) and User Experience (UX).

Skills

Required:
Knowledge of issues pertaining to Medi-Cal and other Health Maintenance Organization (HMO) & Independent Practice Association (IPA) contracts, & payers. 
 
Ability to manage and organize large volumes of information and data.  

Ability to work independently.

Knowledge of regulatory entities and their requirements.

Excellent verbal and written communication skills and excellent interpersonal skills.

Good working knowledge of regulatory requirements/standards.

Ability to solve complex issues and identify creative solutions.

Computer ease and literacy with Word, Excel, PowerPoint, Access, Visio, SQL, and Tableau.

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: Risk Management, Finance

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