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Program Manager, Sr. (Student Behavioral Health Incentive Program) (1 Year Position)
Job Description
Department(s): Contracting
Reports to: Director II
FLSA status: Non-Exempt
Salary Grade: M – $85,000 – $141,086
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 Tuesday, November 21, 2023 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 Sr will effectively manage all aspects of the Student Behavioral Health Incentive Program (SBHIP) contracting project throughout its lifecycle in coordination with CalOptima’s Behavior Health department under the direction of the Director of Contracting. This incumbent will be responsible for the overall management, negotiation, coordination, project planning, tracking, oversight and operational implementation of high visibility/complex SBHIP contracts and Memorandum of Understanding (MOUs) with school districts. The incumbent will interact with the Orange County Department of Education (OCDE) and 29 school districts to help them gain an understanding of the Medi-Cal health plan contracting process and Medi-Cal billing and payment requirements for behavioral health services. This incumbent will coordinate and collaborate with multiple impacted areas throughout the organization. The incumbent may manage other provider network contracts as determined by the Contracting leadership.
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.
• Serves as the contact representing the Contracting department’s lead contact as the subject matter expert for SBHIP’s contract documents and requirements.
• Leads SBHIP contracting efforts and operational project planning, implementation and management in collaboration with CalOptima Health’s Behavioral Health department and other internal departments.
• Coordinates and implements complex SBHIP provider contracts and MOUs with the school districts in Orange County, within defined timelines and targets.
• Facilitates positive and collaborative communications with the OCDE and 29 school districts in Orange County to ensure SBHIP goals and objectives are achieved.
• Develops detailed project plans, tasks, due dates and tracks progress of contracts and operational implementation of the contracts.
• Provides regularly scheduled updates to Contracting leadership and Director of Behavioral Health Services (or designee) regarding the status of the contracts/MOUs and operational implementation of the contracts/MOUs once the agreements are executed.
• Analyzes, identifies, implements and manages changes to project scope, schedule and resources.
• Researches specific contracting and operational issues, develops and analyzes options and makes recommendations to keep the project moving forward.
• Works with providers and their related business personnel to implement and manage provider contracts.
• Maintains effective interpersonal relationships with stakeholders and works with the stakeholders to resolve issues proactively.
• Works with executives and leadership to identify and problem-solve complex SBHIP provider contracting and/or operational issues, as needed.
• Coordinates with Legal to prepare and update contracts and related materials as needed.
• Completes other projects and duties as assigned.
Experience & Education:
• Bachelor’s degree required.
• 3 years of experience in managed care within any of the following areas: Contracting, Provider Relations, Program/Project Management, Claims/Customer Service or Analytics with a health plan or large provider delivery system required.
• 2 years of experience managing and implementing complex projects in a health care delivery system required.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.
Preferred Qualifications:
• 3 years of Medi-Cal managed care contracting experience in Southern California market.
• General experience working with school districts.
Physical Demands and 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: While performing duties of job, employee may be required to move about the organization. Employee must be able to sit for extended periods of time, as well as 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. Must also be able to reach with hands and arms and must occasionally lift office supply boxes or laptop case while traveling, up to 25 pounds. Employee must be able to communicate, particularly for regular phone use, in meetings, face-to-face interaction and while presenting.
• Work Environment: Typical office environment with minimal to 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 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.
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.
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.
Physical Demands and 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: While performing duties of job, employee may be required to move about the organization. Employee must be able to sit for extended periods of time, as well as 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. Must also be able to reach with hands and arms and must occasionally lift office supply boxes or laptop case while traveling, up to 25 pounds. Employee must be able to communicate, particularly for regular phone use, in meetings, face-to-face interaction and while presenting.
• Work Environment: Typical office environment with minimal to 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 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.
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.
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.
Job Location: Orange, California
Position Type:
To apply, visit https://apptrkr.com/4905327
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