Current jobs related to Manager, Medical Management - Los Angeles, California - L.A. Care Health Plan
-
Outpatient UM Coordinator
3 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob DescriptionJob SummaryThe Outpatient UM Coordinator provides effective communication between MSO, IPA providers, and members to coordinate member care. Communication to include accessibility to care, validating contract entities, and ensuring timeliness standards are met. The Outpatient UM Coordinator reports directly to the Outpatient Lead Coordinator...
-
Maintenance Operations Manager
3 weeks ago
Los Angeles, California, United States GHP Management Full timeAbout the RoleGHP Management is seeking a highly skilled and experienced Maintenance Operations Manager to join our team. As a key member of our community management team, you will be responsible for ensuring the highest level of service excellence and maintaining a safe, respectful, and productive environment for all team members.Key...
-
Outpatient Utilization Manager
37 minutes ago
Los Angeles, California, United States MedPOINT Management Full timeJob SummaryWe are seeking a highly skilled Outpatient UM Clinician to join our team at MedPOINT Management. As a key member of our Utilization Management department, you will play a critical role in ensuring that our members receive high-quality, cost-effective care.Key ResponsibilitiesReview and process precertification requests for medical necessity,...
-
Maintenance Operations Manager
3 weeks ago
Los Angeles, California, United States GHP Management Full timeAbout the RoleWe are seeking a highly skilled and experienced Maintenance Operations Manager to join our team at GHP Management. As a key member of our community team, you will be responsible for ensuring the highest level of service excellence and asset preservation within our communities.Key ResponsibilitiesCustomer Service and Leadership: Create and...
-
Maintenance Operations Manager
2 weeks ago
Los Angeles, California, United States GHP Management Full timeAbout the Role:The Maintenance Manager will be responsible for leading a team of maintenance professionals to ensure the highest level of service excellence in our communities. This includes creating a safe, respectful, and productive work environment, providing leadership and guidance to the team, and efficiently handling resident requests and...
-
Maintenance Operations Manager
3 weeks ago
Los Angeles, California, United States GHP Management Full timeAbout the Role:The Maintenance Operations Manager will be responsible for leading a team of maintenance professionals to ensure the highest level of service excellence and asset preservation within our communities. This role requires a strong leader who can inspire and motivate their team to achieve exceptional results.Key Responsibilities:Lead a team of...
-
General Manager
1 week ago
Los Angeles, California, United States Action Property Management Full timeAction Property Management is seeking a seasoned General Manager to lead our Summit on Sixth community in Los Angeles, California. As a key member of our team, you will be responsible for providing expert guidance to the Association and Board of Directors on matters related to California Common Interest Development law and high rise requirements. Your...
-
Maintenance Operations Manager
2 weeks ago
Los Angeles, California, United States GHP Management Full timeAbout the RoleGHP Management is seeking a highly skilled and experienced Maintenance Operations Manager to join our team. As a key member of our facilities management team, you will play a critical role in ensuring the maintenance and upkeep of our properties.Key ResponsibilitiesCustomer Service: Provide exceptional customer service to residents and...
-
Site Operations Manager
2 days ago
Los Angeles, California, United States IST Management Full timeAbout the RoleWe are seeking a highly skilled and experienced Site Supervisor to join our team at IST Management Services in Century City, CA. As a Site Supervisor, you will be responsible for providing exceptional corporate hospitality and receptionist services, as well as supporting daily operations.Key ResponsibilitiesManage daily operations and reporting...
-
HOA General Manager
2 days ago
Los Angeles, California, United States Seabreeze Management Full timeJob Title: HOA General ManagerSeabreeze Management Company is seeking a highly skilled and experienced HOA General Manager to join our team. As a key member of our management team, you will be responsible for overseeing the day-to-day operations of our homeowner associations, ensuring that our communities are well-managed and that our residents receive...
-
Outpatient Utilization Management Specialist
4 weeks ago
Los Angeles, California, United States MedPOINT Management Full timeJob OverviewPosition: Outpatient Utilization Management Specialist at MedPOINT ManagementRole SummaryThe Outpatient Utilization Management Specialist is essential in enhancing communication between Managed Services Organizations (MSO), Independent Physician Associations (IPA), and members to guarantee seamless member care. Key responsibilities include...
-
Maintenance Operations Manager
6 days ago
Los Angeles, California, United States GHP Management Full timeAbout the RoleWe are seeking a highly skilled and experienced Maintenance Operations Manager to join our team at GHP Management. As an Assistant Maintenance Manager, you will play a critical role in maintaining our properties in the best possible condition, ensuring a quality living environment for our residents.Key ResponsibilitiesCreate a sense of...
-
Maintenance Manager Assistant
2 days ago
Los Angeles, California, United States GHP Management Full timeAbout the RoleWe are seeking a highly skilled and experienced Maintenance Manager Assistant to join our team at GHP Management. As an Assistant Maintenance Manager, you will play a critical role in maintaining our properties in the best possible condition, ensuring a quality living environment for our residents.Key ResponsibilitiesCreate a sense of community...
-
Community Manager
4 weeks ago
Los Angeles, California, United States WSH Management, Inc. Full timeJob OverviewPosition: Community ManagerCompany: WSH Management, Inc.Location: Los Angeles, CAPosition SummaryWSH Management, Inc. is in search of a dedicated full-time Community Manager for a 103-unit affordable housing apartment complex. This facility caters to seniors aged 62 and above, with a portion of the units allocated for individuals transitioning...
-
Los Angeles, California, United States Southern California Management Company Full timeDynamic Talent Acquisition Specialist for a Premier Medical Management FirmPosition Title: Dynamic Talent Acquisition Specialist for a Premier Medical Management FirmLocation: Southern CaliforniaAre you prepared to transform the talent acquisition landscape? Do you possess the skills to discover outstanding candidates and propel organizational success?About...
-
Maintenance Operations Manager
3 weeks ago
Los Angeles, California, United States GHP Management Full timeAbout the RoleGHP Management is seeking a highly skilled and experienced Maintenance Operations Manager to join our team. As an Assistant Property Manager, you will play a crucial role in maintaining the quality living environment for our residents by ensuring our properties are well-maintained and in excellent condition.Key ResponsibilitiesCustomer Service:...
-
Maintenance Operations Manager
3 weeks ago
Los Angeles, California, United States GHP Management Full timeAbout the RoleGHP Management is seeking a highly skilled and experienced Maintenance Operations Manager to join our team. As an Assistant Property Manager, you will play a crucial role in maintaining the quality living environment for our residents by ensuring our properties are well-maintained and in excellent condition.Key ResponsibilitiesCustomer Service:...
-
Maintenance Manager
3 weeks ago
Los Angeles, California, United States GHP Management Full timeAbout the RoleWe are seeking a highly skilled and experienced Maintenance Manager to join our team at GHP Management. As an Assistant Maintenance Manager, you will play a crucial role in maintaining the quality living environment for our residents by ensuring our properties are well-maintained and in excellent condition.Key ResponsibilitiesCustomer Service:...
-
HOA General Manager
2 weeks ago
Los Angeles, California, United States Seabreeze Management Full time{"Job Title": "HOA General Manager", "Job Summary": "Seabreeze Management Company is seeking a highly skilled and experienced HOA General Manager to oversee the daily operations of our community associations. As a key member of our team, you will be responsible for ensuring the smooth operation of our properties, providing exceptional customer service, and...
-
Maintenance Manager Assistant
2 days ago
Los Angeles, California, United States GHP Management Full timeJob Title: Assistant Maintenance ManagerAs a key member of the GHP Management team, the Assistant Maintenance Manager plays a vital role in ensuring the quality living environment for our residents. This position requires a strong attention to detail, practical mindset, and an outgoing and friendly personality.Key Responsibilities:Customer Service:Create a...
Manager, Medical Management
3 months ago
Salary Range: $117, Min.) - $152, Mid.) - $188, 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 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.
The Manager of Medical Management is responsible for the overall day-to-day operations of the staff and activities requiring clinical licensure in the Utilization Management (UM) department. This position will work closely leaders to develop and organize the department's work priorities and deliverables. This position will manage clinical personnel to orchestrate and oversee the completion of tasks requiring clinical determinations. This position will also be responsible for internal and external reporting, and managing the monthly data needed to ensure department metrics are met or exceeded, including but not limited to, productivity, and satisfaction of internal and external customers.
The Manager of Medical Management will also work closely with other LA Care Leaders to ensure that work is being completed accurately and timely. This position will collaborate with interfacing departments to ensure that consistent application of clinical criteria, quality of work, and productivity is maximized. This position will also lead team meetings, develop the UM clinical staff, represent the UM Clinical unit at meetings when applicable, and escalate issues as appropriate. This position manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports.
DutiesOversees and monitors operational compliance with organizational standards, policies and procedures and regulatory requirements. Develops and implements approved departmental policies and procedures/workflows. Implements and monitors departmental performance standards. Performs ongoing monitoring and evaluation of departmental operations to assure optimal efficiency and effectiveness.
Collaborates with department leadership to establish operational objectives for the business unit.
Works with members of cross-functional teams to glean and provide information pertinent to operational goals and acts as an expert resource.
Manage staff , including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others.
Ensures timely and accurate submission of reports/documents to organizational leaders and regulatory agencies.
Assures appropriate department interface with key internal and external stakeholders.
Participates in the development of and is responsible for the implementation of operational business plans and departmental objectives to support organization strategies.
Contributes to departmental statistical, quality and performance reports.
Develops and maintains effective communication mechanisms at various levels of the organization and with external organizations.
Provides input for the departmental budgets.
Leads various committees and workgroups.
Assures the maintenance of positive relationships with other departments, PPGs, other Local Initiatives and Community Based Organizations.
Implements, with approval, programs that improve the provision of services to members.
Manages content for PPG trainings/JOMS. Responsible for oversight and adequate performance of direct line of business PPG delegated activities. Work with department leadership for enhancements as necessary. Develops and sustains active communications with PPGs.
Provide administrative oversight of the L.A Care After Hours programs.
Actively participates in regulatory audits.
Performs other duties as assigned.
Duties ContinuedEducation RequiredBachelor's Degree in NursingIn lieu of degree, equivalent education and/or experience may be considered.Education PreferredExperience
Required:
At least 6 years of clinical nursing experience.
At least 4 years of leading staff or supervisory/management experience.
Minimum of 3 years of relevant health plan experience.
Equivalency: Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.
Preferred:
Experience with Medi-Cal, under-served and culturally diverse populations.
Experience with state Medi-Cal regulations.
Audit/oversight experience.
Skills
Required:
Excellent verbal and written communication skills.
Strong problem solving, planning, and organizational skills.
Ability to maintain confidentiality in compliance with all Health Insurance Portability and Accountability Act (HIPAA) requirements.
Licenses/Certifications RequiredRegistered Nurse (RN) - Active, current and unrestricted California LicenseLicenses/Certifications PreferredRequired Training
Required:
Registered Nurse (RN)Physical RequirementsLightAdditional Information
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.
L.A. Care offers a wide range of benefits including
Paid Time Off (PTO)Tuition ReimbursementRetirement PlansMedical, Dental and VisionWellness ProgramVolunteer Time Off (VTO)