Program Manager (Operations)

$77,863 - $124,581/Yr

CalOptima - Orange, CA

Full-time

Remote - Orange, CA

Insurance Carriers and Related Activities

About the position

CalOptima Health is seeking a highly motivated and experienced Program Manager (Operations) to lead the design, implementation, and evaluation of quality programs. This role involves collaboration with leadership and various departments to ensure the success of quality initiatives and compliance with regulatory standards.

Responsibilities

• Leads program development, execution of activities and oversight of campaigns executed through vendors.
• Tracks and monitors the impact and success of programs.
• Assists management in the development of specifications and scope of work for RFPs, RFQs, or RFIs.
• Collaborates with other departments on program design and implementation of quality programs.
• Supports NCQA accreditation standard initiatives and provides analysis and evaluation.
• Produces documentation, summaries, root cause analyses, and reports for department operations.
• Reviews evidence-based literature for best practices.
• Develops and oversees the process of written tools for programmatic use.
• Collaborates on the development of program measures of success and outcome reports.
• Maintains current knowledge of applicable regulations or clinical guidelines.
• Identifies issues that may impact CalOptima Health's quality program.
• Participates in a mission-driven culture of high-quality performance.
• Assists the team in carrying out department responsibilities.
• Reviews and assists in updating policies and procedures.
• Works with all departments in response to inquiries and problem-solving.
• Completes other projects and duties as assigned.

Requirements

• Bachelor's degree required.
• 3 years of related work experience in program development and/or data analysis, preferably in the health care industry.
• Ability to develop rapport and maintain effective working relationships.
• Strong communication skills, both orally and in writing.
• Ability to work independently and exercise sound judgment.
• Project management skills and ability to manage multiple projects.

Nice-to-haves

• Master's degree in public health, health administration or related field.
• 1 year of experience working in a highly matrixed, mission-driven organization.

Benefits

• Participation in the California Public Employees Retirement System (CalPERS).
• Low-cost medical/vision/dental insurance options.
• Paid time off.
• Flexible scheduling during core business hours.
• Telework options for some positions.
• Wellness program featuring diverse activities.
• 4% contribution to a 401(a) retirement program with no required employee contribution.
• Access to 457(b) retirement plans with pre/post-tax contribution options.