Job Abstract

The Care Management Initiatives Program Manager II is responsible for leading and managing a portfolio of strategic Care Management (CM) programs that are generally complex and large in scope. In this capacity, this position works collaboratively with leadership, management, cross-functional teams, regulatory body representatives, and other stakeholders as appropriate. A key function of this position is to serve as the primary point of contact between Care Management leadership and other program teams, engaging all stakeholders and communicating relevant updates.

This position is accountable for working with and facilitating processes to accomplish complex program objectives, managing change, planning, organizing, directing and supervising program activities to achieve strategic goals and the Care Management vision. This position closely collaborates with business owners, vendors, regulatory body representatives, and other organizational staff to understand the business needs for each project and make decisions based on what is best for the department and organization.

This position supports the development and implementation of Care Management initiatives to comply with regulatory and accreditation requirements such as those stated in contracts, memorandums of understanding, CalAIM Policy Guides, National Committee on Quality Assurance (NCQA) PHM, Department of Health Care Services (DHCS) All Plan Letters (APLs), and Centers for Medicare and Medicaid Services (CMS) Model of Care (MOC).

This position is a role model for integrity and establishes and maintains effective professional work relationships, working collaboratively with all levels of management and business owners to help guide the discipline of planning, organizing, securing, managing, leading, and controlling resources to achieve specific goals. This position oversees and administers all facets of the day-to-day operations of the various programs and activities related to the position.

Critical Thinking & Problem-Solving: Formulate and propose recommended solutions/options to address moderately complex operational and programmatic challenges in care management, with moderate guidance from the Care Management leadership team.   

Accountability: Assume ownership under direction of the department Director or Senior Director, for successful development, planning, and execution of projects, from initial concept to implementation stage, with moderate guidance and supervision from the Care Management leadership team.

Relationship Building: Maintain strong positive working relationships with internal L.A. Care Management staff in order to facilitate mutual collaboration in strategic and operational efforts to improve quality of care and effectiveness of programs and initiatives with moderate guidance and supervision from director.

Program Development: Independently lead the design, development, and enhancement of program solutions to address Care Management operational challenges that require collaboration with multiple external stakeholder and senior management leaders. Expected to serve as a strategic thought partner with the Director, Senior Director, and senior management/leadership team members to advise on strategic programmatic options and for meeting regulatory and accreditation compliance. In addition, this position may ensure executive summaries of new policies and regulatory requirements contrasted against  program compliance are submitted to leadership for review and approval in a timely manner.                                                                                         
Perform other duties as assigned.

Required:

At least 5 years of work experience in health care or a related field, doing policy and/or program implementation work.

Experience building relationships with organizations and business partners.

At least 1 year of experience in leading program/project teams.

Preferred:

Managed care experience.

Required:
Demonstrated critical thinking, problem solving, and program planning and implementation skills.

Demonstrated strong writing and communication skills.

Demonstrated ability to synthesize and analyze qualitative and/or quantitative data.

Knowledge of health care operations or health care systems.