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Managed Care Operations Program Manager III
2 months ago
Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.)
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, 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.
Reporting to the Chief Operating Officer (COO), the Managed Care Operations Program Manager III is a self-motivated, out-of-the-box, critical thinker, who is able to leverage their managed care operations subject matter expertise and experience to support the COO and provide leadership within the Office of the COO to execute a wide-variety of key initiatives and ensure successful implementation between the COO Office and business owners. Scope of responsibilities includes monitoring performance trends for functional areas, developing and improving end-to-end business processes, managing strategic and transformational enterprise wide programs and projects that are generally complex and large in scope, and responsible for managing all aspects from initiation, planning, execution, monitoring, controlling and closing phases. This includes developing and managing operations specific cost center budgets, creating and executing contracts, preparing and reviewing ad-hoc reporting, developing communications and other operational obligations.
The Managed Care Operations Program Manager III is responsible for guiding the daily aspect of the COO's operations, inclusive of overseeing contingent workers. This role works closely with functional area leaders, Operations Services vertical, to identify, refine, and track KPIs to measure progress to enterprise goals, identify risks/issues and drive cross functional process and performance optimization efforts.
The Managed Care Operations Program Manager III prepares program/project executive summary of needs, solutions, costs, benefits, and implementation schedules for the Office of the COO and support other operations executives in doing the same. In addition, the Managed Care Operations Program Manager III presents programs/projects led by the Office of the COO to the Investment Review Board for review and approval, creates definitive project execution plans (Plan of Record), manages change and resolves issues that span project teams and departments by planning, organizing, directing and supervising program activities in a cost effective and productive manner to achieve strategic value and the organizational vision.
The Managed Care Operations Program Manager III serves as the point of contact for external vendors from RFP process initiation, contract creation, project implementation and on-going performance reviews. The Managed Care Operations Program Manager III develops reports, memoranda, and correspondence for Board of Governors meetings, internal and external committee meetings, and reviews information prior to dissemination to mitigate any risk and resolve any issues prior to the COO's involvement. The Managed Care Operations Program Manager III is responsible for ensuring the COO is well prepared to lead or engage in meetings and other functions and may be required to lead or participate in meetings on behalf of the COO. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.
DutiesMonitor operational activities, trends and timelines, communication, and coordination of operations. Provide function-specific information for the COO's office. Prepare and review reports, memos, correspondence and presentations as requested and review information prior to dissemination to mitigate any risk and resolve any issues prior to the COO's involvement. Ensure the COO is well prepared to lead or engage in meetings and other functions and may be required to lead or participate in meetings on behalf of the COO.
Manage the Chief Operating Officer’s overall annual budget, position requirements, requests and control numbers, while monitoring and providing oversight of all cost centers reporting to the COO. Partner with the business leaders across all functional and line of business (LOB) units to communicate the priorities of the COO and provide feedback or follow-ups to key staff members. Oversee the work of contingent workers.
Analyze the business processes in an organization for inefficiencies. Make recommendations for solutions or improvements that can be accomplished through new process or technology, or alternative uses of existing processes or technology.
Elicit, document, analyze, communicate, and verify requirements for managed care and business operations. Assess the requirements of the organization with respect to its function. Review policies, procedures, and internal controls, makes information-based recommendations to the COO. Review transactions, source documents, and disclosures.
As needed, local travel with the COO to off-site business meetings and conferences in support of the COO, in an effort to direct and /or coordinate deliverables, timelines, and key risks/issues.
Function as a strategic partner with the COO/Operations Executive Leadership team to develop communications plan, training plan, risk management/mitigation plan, executive summary of needs and plan of record. Develop and maintain program scope, schedule, cost, quality and project artifacts. Direct cross-functional team to successfully complete projects on time, within scope and on budget. Identify risks, assumptions, issues, and dependencies, provide timely status reports and proactively escalate issues for resolution. Accountable for scheduling, cost tracking/budget, resource management allocation and utilization, program component integration and supporting program performance. Duties Continued Serve as the point of contact for external vendors from Request for Proposal (RFP) process initiation, contract creation, project implementation and on-going performance review. 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. Perform other duties as assigned. Education Required Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.Education Preferred ExperienceRequired:
Minimum of 5 years in Project Management within a Managed Care Organization, provider groups/hospital and/or Top 10 management consulting firm in the healthcare industry.
Experience facilitating and making complex decisions with various executive stakeholders with different interests and priorities.
Experience managing, motivating, communicating and resolving conflict within all levels of staff.
Preferred:
Significant experience in government-sponsored managed care.
SkillsRequired:
Strong qualitative and quantitative analytical skills. Ability to work well and communicate effectively with a diverse group of people, including Executive and Senior Leadership, influence, manage and provide support across multiple functions in an organization. Excellent written and verbal communication skills, with demonstrated proficiency in Microsoft Office tools including Word, Excel, Power Point, Access, Visio. Excellent attention to detail and demonstrated excellence in customer service, possessing a professional and mature demeanor at all times with an ability to make independent judgments, handle multiple projects simultaneously, adapt to shifting priorities and utilize time management skills to meet deadlines. Excellent project management skills, with proven experience managing external and internal stakeholders to gather information, analyze data and processes, support project deliverables, create standard project documents and drive recommendations and action plans cross-functionally. Ability to work well independently or lead a project team/efforts with limited supervision; strong team collaboration.
Ability to understand business or clinical strategies and plans, and their relationship to organizational strategies.
Excellent skills in budget and forecast planning.
Demonstrated critical thinking and problem solving skills.
Knowledge of managed care health insurance industry.
Ability to maintain the highest level of integrity and management of confidential information.
Ability to function as action oriented with excellent work ethic and initiative.
Ability to understand and anticipate the needs of executive leadership and functional areas.
Ability to work in a fast-paced department independently and handle multiple tasks; work with interruptions and deal effectively with confidential information.
Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements LightAdditional InformationRequired:
Travel to offsite locations for work required.
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
This position is a limited duration position. The term of this position is a minimum one year and maximum of two years from the start date unless terminated earlier by either party. Limited duration positions are full-time positions and are eligible to receive full benefits.
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)
