Program Manager jobs at L.A. Care Health Plan - 33 jobs

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (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. Job Summary The Strategic Investments Program Manager II team is responsible for investment projects to address key leadership priorities, including, but not limited to: workforce gaps, provider infrastructure and capacity building, member care management and community health. The position works on projects from concept to implementation stages. This position works with internal and external key stakeholders and senior management to develop and manage investment planning, prioritization, timelines, performance metrics, budgets, outcomes analysis, and investment agreements for various priority initiatives. Duties Develops, designs and implements investments in alignment with specific strategic initiatives to support local workforce needs, provider infrastructure and capacity gaps, and member health outcomes while managing the process and strategic direction of the investments. Responsible for monitoring program budget and expenditures. Plans, develops, and implements strategies for generating funding and/or resource opportunities for program activities. Supports internal planning to identify key investment opportunities. Identifies key contributors, strategy partners, and overall resources required for investment execution and evaluation. Recognizes risks and recommends solutions to mitigate impact on operations and maximize benefit to investment recipients. Conducts needs assessment of investment requirements, scope, budget and timeline for cross-functional department participation and execution. Identifies opportunities for efficiency in scope and ensure program objectives and deliverables are in alignment with department and L.A. Care goals. Drafts agreements, work plans and budgets based on approved funding decisions and desired outcomes. Contributes to annual strategic investment planning in partnership with internal and external stakeholders, including senior leadership. Develops materials to summarize investment plans, general updates, areas of concerns and proposed solutions to advance priority outcomes. Monitors inter-connected programs/project work product, outcome and interplay to be able to make necessary enhancements or modifications as appropriate to ensure alignment with department objectives. Coordinates cross-program/project activities as necessary. Maintains up to date knowledge of compliance requirements and supports with regulatory body reporting, as requested. Assesses program performance and aims to maximize return on investment (ROI), utilizes change management strategies to implement enhancements and process improvements as necessary. Prepares reports as needed for key stakeholders. Performs other duties as assigned. Duties Continued Education Required Bachelor's Degree in Public Health or Related Field In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Public Health or Related Field Experience Required: At least 4 years of work experience doing problem solving, policy, and/or project implementation in a health care or a related field. Experience building relationships with organizations and business partners. At least 1 year of experience in leading project teams. Skills Required: Demonstrated critical thinking, problem solving, and project 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. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Public Health, Healthcare

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. Job Summary The Program Manager III oversees multiple complex programs in the department. This position designs and manages the implementation, operations, and the evaluation of strategic programs or functions of the assigned program of responsibility. The position strategizes implements and maintains program initiatives that adhere to the department's goals. Acts as a Subject Matter Expert, (SME) serves as a resource and mentor for other staff. Duties Aligns program goals with the organizational strategy. Defines and maintains standards for program management within the department. Develop program goals and objectives. Ensure team members have the resources needed to meet their objectives. Responsible for defining the metrics, quality standards, and documentation required for consistent project management and execution across the business Serves as SME for all programmatic processes and procedures. Provide strategic direction to program start-up and closeout activities including development, and refinement of program management tools, resources, and processes. Directly responsible for the financial management of assigned programs including the development, tracking, and updating of budgets; monitoring monthly projections and actuals; obligated funds notifications; budget modifications and other financial matters. Designs and orchestrates the delivery of applicable communication to staff and management to establish goals and strategies related to the program. Oversee the development and implementation of annual work plans, ensuring timely and high-quality reviews and submissions. Collaborates with key stakeholders on program implementation and facilitate communications with cross-functional departments on the status of ongoing activities, manage compliance to scope and reporting requirements. Ensure approval from management are in place. Provides recommendations and guidelines on strategic business development, including the identification and pursuit of new business opportunities, and technical assistance to support full cycle program development. Duties Continued Manage and troubleshoot issues, including but not limited to cross-functional team relations, financial, and regulatory compliance, reporting and documentation. Applies subject matter 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. Ensures that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed. Perform other duties as assigned. Education Required Bachelor's Degree in Related Field Education Preferred Master's Degree in Related Field Experience At least 5 years of strong program management experience with large and complex programs. Experience performing problem solving, policy, and/or program implementation. Experience in overseeing program/project teams Skills Required: Strong ability to build strong relationship management with a diverse set of partners Ability to convey complex information, listen actively, and negotiate effectively. Strong skills in strategic thinking. Ability to Identify and analyze issues, and devise effective solutions. Demonstrated ability to Stay open to change and continuously learn. Understand the wider objectives of the program, such as business and strategic goals. Strong knowledge of budgeting and resource allocation procedures. Licenses/Certifications Required Licenses/Certifications Preferred Program Management Professional (PgMP) Lean Six Sigma Managing Successful Programmes (MSP) Required Training Physical Requirements Additional 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Relationship Manager, Customer Service

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (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. Job Summary The Community Health Program Manager II is responsible for supporting Community Health projects designed to improve both the managed care performance of the L.A. County safety net and the health of vulnerable L.A. Care members. This position shall be responsible for fulfilling a broad range of analytical, planning, engagement, and implementation functions. Primary duties shall include performing research and data analysis, operational and conceptual problem-solving, building partnerships, and project planning, implementation, and monitoring. This position works under the guidance of the Senior Community Health Program Manager or Director on projects from concept to implementation stages and solves complex problems. This position will also initiate and develop strong interpersonal relationships with both internal L.A. Care staff and external business partners in order to facilitate joint decision-making and successful project implementation. As part of the Community Health team, the Program Manager will help L.A. Care and its safety net provider partner's work together to achieve the triple aim of better health quality outcomes, better patient experience of care, and lower cost of care. Duties Critical Thinking & Problem-Solving: Formulate and propose recommended solutions/ options to address moderately complex operational and programmatic challenges in the safety net, with moderate guidance from manager. Accountability: Assume ownership under direction of manager, for successful development, planning, and execution of projects, from initial concept to implementation stage, with moderate guidance and supervision from manager. Stakeholder Engagement: Initiate engagement of existing internal and external business partners colleagues, to jointly problem-solve complex member and provider issues. Facilitate constructive dialogue among internal and external stakeholders to ensure problems are properly assessed, analyzed and resolved, with moderate guidance and supervision from manager. Relationship building: Maintain strong positive working relationships with internal L.A. Care management staff and external business partners, in order to facilitate mutual collaboration in strategic and operational efforts to improve quality of care and costs, with moderate guidance and supervision from manager. Project Planning & Implementation: Independently write comprehensive project work plans that define the project purpose, scope, key milestones and tasks necessary to guide the implementation of a program initiative: Maintain work plan updates to capture any changes that arise throughout the project implementation phase; Manage the project team's progress and performance as it relates to the project tasks; track and report on project status; Identify issues that must be escalated in order to ensure timely completion of project; Manage internal and external meetings, including the development of agendas and objectives; Propose solutions to address and mitigate any anticipated project delays and steer project in positive direction. Active participation in internal & external initiatives: With moderate guidance and supervision from manager: Serve as L.A. Care business project lead in external stakeholder meetings on behalf of the Safety Net Initiatives Unit, as required; Serve as L.A. Care business project lead and actively participate in L.A. Care committee standing meetings and management meetings on behalf of the Safety Net Initiatives Unit, as required; Provide subject matter expertise and input to inform organizational decision making. Educational Presentations: With moderate guidance and supervision from manager, develop learning objectives, create materials for, and deliver educational presentations in small and large group settings to internal and external non-senior management level audiences, in order to inform and update them on relevant managed care program, product, and policy developments. Perform other duties as assigned. Duties Continued Education Required Bachelor's Degree in Health Care or Public Health or Related Field In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Health Care or Public Health or Related Field Experience Required: At least 5 years work experience in health care or a related field, doing problem solving, policy, and/or project implementation. Experience building relationships with organizations and business partners. At least 1 year of experience in leading project teams. Skills Required: Demonstrated critical thinking, problem solving, and project 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. Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information Program Specifics: Housing Initiatives: The Housing Initiatives team provides housing navigation and tenancy services to thousands of homeless and formerly homeless L.A. Care members using a network of contracted providers. Responsibilities associated with the Housing Initiatives team include analysis of housing data on enrollment, payment, or claims data to identify operational problems or issues. Make recommendations to resolve problems and/or improve operations and quality of the housing program. Community Health Platform: The Community Health Platform team supports and develops the infrastructure upon which Community Health initiatives operate. This operational and policy infrastructure includes claims processing, provider network management, community engagement, data and reporting, and compliance activities. 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Public Health, Claims, Medical, Healthcare, Insurance

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (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. Job Summary The Program Manager (PM) II oversees one or more programs ensuring that the department management and key stakeholders define the program goals. This position is responsible for developing program assessment protocols for effectiveness and quality improvement. The PM II maintains the program standards of quality and performance. This position oversees the program budget for maximum utilization of resources. Duties Participates and recommends in setting program goals and objectives. Ensure team members have the resources needed to meet their objectives. Provide recommendations on financial management of assigned programs including developing, tracking, and updating budgets; monitoring monthly projections and actuals; obligated funds notifications; anticipate budget modifications and other financial matters. Monitors program operations for quality, efficiency and effectiveness. Utilizes a client relationship management (CRM) or another system to organize information and facilitate outreach communications, perform forecasting, and measure the performance of programs. Develop and implement annual work plans; ensure timely and high-quality reviews and submissions of deliverables; Prepare scopes of work and monitoring service delivery. Work with key stakeholders on program implementation and facilitate communications with cross-functional departments on the status of ongoing activities, manage compliance to scope and reporting requirements. Obtain approvals from management. Support new business/ program development including cost proposals, recruitment, collaborating, research/writing, coordinating activities. Duties Continued Identify issues or potential risks, consult with the key stakeholders and management, and make informed decisions on how to address issues, communicating when appropriate with senior management. Review, edit, and contribute to technical deliverables and manage field assignments as required. May work with vendors, consultants and government agencies that may include vendor management responsibilities. Perform other duties as assigned. Education Required Bachelor's Degree in Related Field In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Related Field Experience At least 4 years of work experience performing problem solving, policy, and/or program implementation. Skills Required: Ability to work and communicate effectively with internal and external key stakeholders. 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. Licenses/Certifications Required Licenses/Certifications Preferred Certificate in Program Management Program Management Professional (PgMP) Required Training Physical Requirements Light Additional 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Relationship Manager, Customer Service

Your Role The Quality Review team completes audits of front-line staff to ensure alignment with department processes and regulatory compliance. The Quality Review team also provides coaching and works closely with business leaders to drive optimal results. The Sr. Manager, Clinical Quality Review, will report to the Director, Program Management Clinical. In this role you will be providing oversight and leadership to the Quality Review team by evaluating performance, tracking to team goals, and ensure that staff have the skills and knowledge required to be successful in their auditing duties and maintaining target productivity. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Your Knowledge and Experience Requires at least 10 years of prior relevant experience including 4 years of direct people management experience. Bachelor of Science in Nursing or advanced degree preferred Requires a current California RN License. Strong understanding of Blue Shield of California lines of business and Health Solutions Operations as related to various regulatory (NCQA, DMHC, DHCS, CMS) and internal compliance requirements preferred. Strategic thinking and decision-making. Proficiency in management and process improvement. Ability to manage complex projects and competing priorities. Strong communication and presentation skills. Your Work In this role, you will: Lead a high-performing team by setting clear goals, providing guidance, and driving strategies aligned with organizational objectives. Foster accountability, collaboration, and continuous learning to achieve operational excellence. Ensure team compliance with best practices and regulatory requirements while developing innovative approaches to enhance quality assurance processes. Establish and monitor team goals and monthly targets. Implement streamlined reporting to track progress, identify barriers, and recommend improvements while maintaining fiscal responsibility. Perform clinical audits as needed to ensure team compliance with regulatory standards, internal policies, and quality assurance of business requirements. Identify process improvement opportunities to optimize team performance. Build strategic relationships with stakeholders to ensure successful HQA quality assurance outcomes and assess audit needs across business functions. Communicate audit finding trends to business leaders and collaborate with training facilitators to drive quality assurance and continuous improvement. Oversee annual NCQA Inter-Rater Reliability requirements, processes, and reporting. Present Quality Review Team processes and outcomes during regulatory audits and committee meetings. Ensure consistent year-over-year performance with audits meeting or exceeding targets Coach and develop the Quality Review team, fostering growth and engagement.

Your Role The Pharmacy Production Stabilization team provides management and end-to-end oversight of all Pharmacy production stabilization issues, driving issues from identification to resolution within a matrixed environment. The Senior Manager of the Pharmacy Production Stabilization team will report to the Director of Pharmacy Performance. In this role you will be responsible for the management and ownership of the end-to-end activities needed to bring all pharmacy production stabilization issues to full resolution, develop executive level communications and reporting to keep key stakeholders informed of status, and support annual readiness activities. Leading a team of professionals, you will drive processes and business efficiencies in support of our culture of affordability. This position will work closely with the Pharmacy Strategy and Operations team, cross-functionally with other teams within Blue Shield, as well as with our external vendor partners to ensure timely and accurate resolution of pharmacy production stabilization issues. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Your Knowledge and Experience Requires a bachelor's degree or equivalent experience Requires at least 10 years of prior relevant experience, including 4 years of management experience Advanced knowledge of pharmacy operations at the health plan level Experience driving strategic projects and partnering cross-functionally as well as with external vendor partners to achieve successful outcomes Excellent verbal and written communication skills that exhibit a solution-oriented approach Excellent analytical and problem-solving skills Demonstrated leadership, project management, and program evaluation skills Your Work In this role, you will: Partner with business drivers to execute on sub portfolio delivery including schedule, scope, resource management, financials, benefit tracking, knowledge of emerging technologies and issue/risk management to ensure successful completion of all projects and programs in support of the business strategies Partner with managers to manage intake, Rough Order of Magnitude (ROM) estimation and demand/ capacity to ensure projects within the program meet cost, resource, environment, schedule, and other constraints within their domain Provide oversight and direction of all the projects and releases within the sub portfolio (schedule, issues/risks, budget, resources, and PPM/PWA adherence) Oversee and manage senior project managers, project managers and analysts in support of the delivery of the sub portfolio Be accountable for ensuring overall program and project delivery, schedule and budget attainment, and effective management of leadership expectations in achieving overall desired outcomes, results, and deliverables Provide direction, ownership, and oversight over the end-to-end Blue Shield production stabilization process, including Blue Shield and vendor specific incidents to assure that production stabilization issues that are partially or fully caused by contracted vendors and affiliated companies are resolved timely and accurately Manage intake, assignment, direction, and resolution on pharmacy production stabilization issues and solutions that affect the Blue Shield book of business, including collaboration with stakeholders at all levels, identification of downstream impacts to ensure that issues are fully remediated without unintended negative consequences and identifying production stabilization issue trends, operational improvement opportunities, and providing expert recommendations to stakeholders and vendors Assures that all production stabilization incidents have complete documentation from root cause analysis, impact reports, solution alternatives, decisions, communication plan, and implementation Oversee and manage activities related to supporting the Pharmacy Annual Readiness and Command Center (RxARCC) team. Oversee and manage activities related to maintaining the pharmacy business continuity plan including annual reviews and audits Other duties as assigned

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (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. Job Summary The Development Program Manager II supports the Strategic Investment, Innovation and Partnership team to advance core strategic initiatives, achieve impact and network and collaborate with key stakeholders, including funders and other experts in field. This leads development opportunities to leverage resources and impact investments and partnerships at L.A. Care. The position primarily provides support with research and funding opportunities and in addition supports investment program management as needed. The Program Manager (PM) II oversees one or more programs ensuring that the department management and key stakeholders define the program goals. This position is responsible for developing program assessment protocols for effectiveness and quality improvement. The PM II maintains the program standards of quality and performance. Duties Work with key stakeholders on program implementation and facilitate communications with cross-functional departments on the status of ongoing activities, manage compliance to scope and reporting requirements. Obtain approvals from management. Support new business/ program development including cost proposals, recruitment, collaborating, research/writing, coordinating activities. Responsible for research development opportunities. Research foundations and funders for opportunities to help leverage initiatives. Research other private and public stakeholders to support strategic relationships and partnership. Lead work to identify funding partners to leverage impact investments to support health care. Provide recommendations on financial management of assigned programs including developing, tracking, and updating budgets; monitoring monthly projections and actuals; obligated funds notifications; anticipate budget modifications and other financial matters. Review, edit, and contribute to technical deliverables and manage field assignments as required. Provides program management support for strategic partnerships, relationships and investments (email, social and print) and membership. Contribute to L.A. Care's investments, partnerships and giving culture. Works as program manager for investment and partnership work from coordinating campaigns, production, timelines, mailing lists and website information. Develop and implement annual work plans; ensure timely and high-quality reviews and submissions of deliverables; Prepare scopes of work and monitoring service delivery. Participates and recommends in setting program goals and objectives. Ensure team members have the resources needed to meet their objectives. Identify issues or potential risks, consult with the key stakeholders and management, and make informed decisions on how to address issues, communicating when appropriate with senior management. Works with databases to track strategic investments across organization, partnerships. Monitors program operations for quality, efficiency and effectiveness. Maintain an up-to-date internal database of key contacts for strategic investments and partnerships, including creating regular communication channels and opportunities for site visits of future partnerships and investments. May work with vendors, consultants and government agencies that may include vendor management responsibilities. Performs other duties as assigned. Duties Continued Education Required Bachelor's Degree in Business or Related Field In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Business Administration or Related Field Experience Required: At least 4 years of experience in Project/Program Management. Experience in managing complex initiative and multiple projects simultaneously. Experience with working with grants. Experience in building and maintaining relationships with cross-functional internal and external key stakeholders. Experience leading professional staff and fostering accountability, collaboration, and results-oriented performance. Preferred: At least 2 years foundation or development experience or related experience. Experience with Salesforce database products. Experience within managed care, public health, or government-sponsored health insurance programs. Experience in strategic portfolio management, governance, or organizational transformation within healthcare or public-sector environments. Skills Required: Knowledge and understanding of the philanthropic, business and other key stakeholder's communities. Proficiency with Microsoft Office applications and an overall willingness to learn new applications. Knowledge of Concur, QuickBooks, Square, website maintenance tools a plus. Understanding of fundraising principles, techniques, and best practices. Excellent interpersonal skills with commitment to customer service. Exceptional communication skills both verbal and written. Must be a competent writer with editing strengths. Highly organized, systems-oriented, strong analytical abilities. Demonstrated ability to maintain a high degree of accuracy and confidentiality with financial and donor-related data. Working knowledge of Project management techniques and tools. Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members. Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision. Strong ability to make informed decisions. Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges. Preferred: Familiarity with California Medicaid (Medi-Cal) and regulatory entities such as Department of Health Care Service (DHCS), Centers for Medicare and Medicaid Services (CMS), or Department of Managed Health Care (DMHC). Knowledge of health care operations or health care systems. Licenses/Certifications Required Licenses/Certifications Preferred Certified Professional in Healthcare Quality (CPHQ) Certificate in Program Management Program Management Professional (PgMP) Required Training Physical Requirements Light Additional 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Medicaid, Medicare, Philanthropic, Philanthropy, Public Health, Healthcare, Nonprofit

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (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. Job Summary The Development Program Manager II supports the Strategic Investment, Innovation and Partnership team to advance core strategic initiatives, achieve impact and network and collaborate with key stakeholders, including funders and other experts in field. This leads development opportunities to leverage resources and impact investments and partnerships at L.A. Care. The position primarily provides support with research and funding opportunities and in addition supports investment program management as needed. The Program Manager (PM) II oversees one or more programs ensuring that the department management and key stakeholders define the program goals. This position is responsible for developing program assessment protocols for effectiveness and quality improvement. The PM II maintains the program standards of quality and performance. Duties Work with key stakeholders on program implementation and facilitate communications with cross-functional departments on the status of ongoing activities, manage compliance to scope and reporting requirements. Obtain approvals from management. Support new business/ program development including cost proposals, recruitment, collaborating, research/writing, coordinating activities. Responsible for research development opportunities. Research foundations and funders for opportunities to help leverage initiatives. Research other private and public stakeholders to support strategic relationships and partnership. Lead work to identify funding partners to leverage impact investments to support health care. Provide recommendations on financial management of assigned programs including developing, tracking, and updating budgets; monitoring monthly projections and actuals; obligated funds notifications; anticipate budget modifications and other financial matters. Review, edit, and contribute to technical deliverables and manage field assignments as required. Provides program management support for strategic partnerships, relationships and investments (email, social and print) and membership. Contribute to L.A. Care's investments, partnerships and giving culture. Works as program manager for investment and partnership work from coordinating campaigns, production, timelines, mailing lists and website information. Develop and implement annual work plans; ensure timely and high-quality reviews and submissions of deliverables; Prepare scopes of work and monitoring service delivery. Participates and recommends in setting program goals and objectives. Ensure team members have the resources needed to meet their objectives. Identify issues or potential risks, consult with the key stakeholders and management, and make informed decisions on how to address issues, communicating when appropriate with senior management. Works with databases to track strategic investments across organization, partnerships. Monitors program operations for quality, efficiency and effectiveness. Maintain an up-to-date internal database of key contacts for strategic investments and partnerships, including creating regular communication channels and opportunities for site visits of future partnerships and investments. May work with vendors, consultants and government agencies that may include vendor management responsibilities. Performs other duties as assigned. Duties Continued Education Required Bachelor's Degree in Business or Related Field In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Business Administration or Related Field Experience Required: At least 4 years of experience in Project/Program Management. Experience in managing complex initiative and multiple projects simultaneously. Experience with working with grants. Experience in building and maintaining relationships with cross-functional internal and external key stakeholders. Experience leading professional staff and fostering accountability, collaboration, and results-oriented performance. Preferred: At least 2 years foundation or development experience or related experience. Experience with Salesforce database products. Experience within managed care, public health, or government-sponsored health insurance programs. Experience in strategic portfolio management, governance, or organizational transformation within healthcare or public-sector environments. Skills Required: Knowledge and understanding of the philanthropic, business and other key stakeholder's communities. Proficiency with Microsoft Office applications and an overall willingness to learn new applications. Knowledge of Concur, QuickBooks, Square, website maintenance tools a plus. Understanding of fundraising principles, techniques, and best practices. Excellent interpersonal skills with commitment to customer service. Exceptional communication skills both verbal and written. Must be a competent writer with editing strengths. Highly organized, systems-oriented, strong analytical abilities. Demonstrated ability to maintain a high degree of accuracy and confidentiality with financial and donor-related data. Working knowledge of Project management techniques and tools. Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members. Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision. Strong ability to make informed decisions. Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges. Preferred: Familiarity with California Medicaid (Medi-Cal) and regulatory entities such as Department of Health Care Service (DHCS), Centers for Medicare and Medicaid Services (CMS), or Department of Managed Health Care (DMHC). Knowledge of health care operations or health care systems. Licenses/Certifications Required Licenses/Certifications Preferred Certified Professional in Healthcare Quality (CPHQ) Certificate in Program Management Program Management Professional (PgMP) Required Training Physical Requirements Light Additional 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Public Health, Medicaid, Medicare, Philanthropic, Philanthropy, Healthcare, Nonprofit

Your Role The Clinical Quality [Commercial Populations] team is accountable for the quality ratings achieved for the organization's Commercial populations, as well as the preventive care strategy and outcomes for Blue Shield of California's Commercial members. Clinical Quality also manages financial, multi-site, system, and transitions of care risks associated with Quality performance. The Program Manager, Principal (Behavioral Health Preventive Care Outcomes) will report to the Sr. Manager/Director of Clinical Quality. In this role you will create and drive the improvement strategy for preventive care outcomes in behavioral health, with a focus on multi-site care, transitions of care, and emerging HEDIS measures of mental health. Additionally, in close partnership with department leadership, you will develop and implement the operational roadmap for care gap closure through data system improvements, member support interventions, or provider engagement strategies, including but not limited to education, support and remediation activities. Specifically, the role leads annual planning for quality/improvement/equity activities and negotiates resources, workplans and timelines to achieve HEDIS and CAHPS results, as well as state contract requirements related to depression screening, follow up care after emergency room and hospital utilization, and equitable health outcomes. The role is accountable for refreshing, executing and evaluating annual plans and strategies that cascade and scale to multiple teams and functions. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. This position requires an in-office presence two days per week (eight days per month). The office location options for this role are Oakland, Long Beach, Woodland Hills or Rancho Cordova. Your Knowledge and Experience Requires a bachelor's degree or equivalent experience Requires a minimum of 10 years of prior relevant experience Requires demonstrated knowledge of Quality Ratings Systems, including HEDIS, hospital, emergency room, behavioral health and CAHPS measurement Requires a minimum of 7 years of demonstrated experience in behavioral health systems, workflows and teams Requires experience executing improvement initiatives within or with a California based healthplan as well as experience executing member or provider engagement interventions in support of preventive care outcomes and improvement for a diverse member population Requires demonstrated experience with annual financial modeling and operational planning in environments of rapid execution as well as demonstrated knowledge of strategic planning and multi-year project and program management Requires demonstrated ability to communicate complex ideas simply and succinctly both verbally and in writing, including ability to speak comfortably and extemporaneously to diverse audiences, capable of self-management and exhibits a self-starter attitude as well as demonstrated experience and strong skills assembling presentations for executive audiences, including guiding teams to gather pertinent information, and navigating a variety of presentation formats for various audiences Your Work In this role, you will: Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of California strategic goals Consult with all levels including senior management, make recommendations, and influence decision-making Leverage cross-functional internal and external relationships to drive initiatives forward Plan and implement multiple and extremely complex projects/programs spanning across businesses Work collaboratively with teams to develop and implement quality targets and assist monitoring and collecting quality measures Determine key business issues, develop effective action plans and implement to successful quality outcomes conclusions Be responsible for planning and implementation of cross-functional quality improvement programs aimed at improving preventive mental health care, which will encompass multiple projects, initiatives, functions and specialties and include the evaluation/analysis of complex data, financial inputs as well as intangible variance factors Coordinate and oversee the delivery of ambitious targets across multiple internal and external project teams of 5 to 10 people, creating structure to coordinate parallel tracks of work and information for rapid decision making Drive care gap closure and health outcomes in behavioral health sites of care and primary care through Clinical Quality units to maximize improvement and goal achievement Assist with budget planning as part of the annual budget cycle Create and execute annual strategies and execution cycles for new and ongoing member interventions in collaboration with internal and external teams and Leadership

Your Role The Digital Care Programs Operations team provides the opportunity to lead vital aspects of the digital health strategy and execution. The team manages the award winning Wellvolution programs and platform. The Program Manager, Principal will report to the Sr. Manager, Digital Care Programs Operations. In this role you will provide thought leadership for our digital health initiatives, program strategy and implementation for BSC members, which includes all lines of business, program operations, analysis, outcomes measurement and continuous quality improvement including program and vendor management for our Wellvolution platform. The Program Manager, Principal will act as liaison to internal BSC internal teams, legal, IT, privacy, product, Global Business Services, MCS and others, for contracting needs and to expand the knowledge and adoption of digital care programs per the long-term strategic initiatives of BSC and ensure smooth day-to-day operations that are within budget and achieve expected outcomes. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Your Knowledge and Experience Requires a bachelor's degree or equivalent experience Requires at least 10 years of prior relevant experience Master's degree strongly preferred 7-10 years' experience in healthcare managing digital health programs or health products and vendors Strong negotiation skills and ability to successfully interact with all levels of management Detail-oriented with the ability to work in a fast-paced environment required Demonstrate ability to manage challenging situations in a positive and constructive manner Exhibits “can do” attitude and solution-oriented approach to resolve challenges Possesses strong collaboration and partnership skills in a matrixed work environment Able to work independently with minimum direction or supervision required Produces accurate work under tight deadlines Possesses strong business acumen with proven experience in thinking strategically Your Work In this role, you will: Primary responsibility over Wellvolution vendor, managing day-to-day deliverables and adherence to Statement of Work, forecasting enrollments and costs, determining program budgets and contractual obligations Meticulous creation and execution of project plans, deliverable and timelines for digital care program initiatives Experience planning and learning major initiatives, such as the launch of new Wellvolution programs Ability to effectively maneuver through organizational dynamics and tailor approach to ensure optimal outcome Proven ability to determine key business issues, develop effective short- and long-term action plans and implement to successful conclusion Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of California strategic goals Consult with all levels including senior management, make recommendations, and influence decision-making Leverage cross-functional internal and external relationships to drive initiatives forward Plan and implement multiple and extremely complex projects/programs spanning across business areas Determine key business issues, develop effective action plans and implement to successful conclusion

Your Role The Compliance and Ethics team ensures adherence to the BSC Code of Conduct and owns and coordinates the Company's compliance and ethics program across the enterprise, including all business units, products, services and activities. This includes the implementation and maintenance of proper preventive, detective and remedial programs and controls; the execution of relevant policies and procedures; training and educating the workforce; implementing an effective communications program; ensuring effective testing, auditing, monitoring, tracking and reporting; and remediate control deficiencies. This Senior Level Compliance and Ethics Specialist is a critical individual contributor and program lead who will report to the Senior Manager, Compliance and Ethics. In this role you will work closely with the Senior Manager and department to drive and lead the department's strategic priorities and projects, including advancing the compliance training program, developing and implementing compliance policies such as the Conflict of Interest, Gifts and Entertainment, Anti-Corruption, etc., and serve as a subject matter expert on compliance issues, providing guidance and support to various departments within the organization. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Your Knowledge and Experience Requires a Bachelor's degree; Masters in relevant field or Juris Doctor preferred Requires a minimum of 5 years of prior relevant experience (experience in a health plan or related health care organization preferred) Certification in Healthcare Compliance (CHC) or Certified Ethics and Compliance Professional (CCEP) preferred Exceptional written and verbal communication skills, including the ability to explain complex regulatory requirements to diverse audiences Experience with project management preferred. Excellent execution skills required Working knowledge of healthcare regulations and compliance requirements, including the DOJ Federal Sentencing Guidelines, OIG Compliance Plan, Privacy Rules, Stark Law, Anti-kickback statute, and Fraud and Abuse Experience collecting and analyzing data and developing sophisticated reports on compliance and ethics data and metrics Advanced presentation skills, including PowerPoint, Excel, Word Experience and success in program/project management and driving change Key necessary competencies include critical thinking, business acumen, collaboration, ability to influence others, strong written and verbal communication, efficient time management, and excellent organizational & problem-solving skills Your Work In this role, you will: Provide guidance, quality review and execution of compliance and ethics case management and compliance activities Responds to inquiries and provides advice and guidance regarding BSC's Code of Conduct, Corporate Compliance owned policies, and C&E Program operations. Triage and refer cases or inquiries to other BSC compliance resources (e.g., Privacy Office, SIU, Employee Relations) Support the coordination and management of the Corporate Compliance & Ethics communication portals including email boxes, web applications, and Navex EthicsPoint hotlines Designs and develops presentations and resources, implements and promotes awareness of the organization's compliance and ethics policies and the Code of Conduct. Review and analyze compliance metrics, performance data, and monitoring results to identify trends and areas requiring improvement Proactively supports Conflict of Interest (COI) disclosure and assessment activities, including reviewing and responding to guidance requests pertaining to COIs and handling of disclosures Serve as a subject matter expert on compliance issues, providing guidance and support to various departments within the organization. This includes staying current with industry trends and regulatory changes, proactively and continuously improving the compliance program to address new challenges and requirements. Coordinate and respond to requests for Compliance Program documentation and records including surveys, assessments, compliance certifications, attestations, and audit related requests for C&E records Collaborate with colleagues and stakeholders across the BSC enterprise to drive compliance and ethics workplans and projects and exercise independent drive and judgment to suggest and move forward program improvements and priorities Collaborate, as necessary, with other compliance resources (e.g., Privacy, IT Security, Human Resources, operational management) with respect to identified compliance issues Develops and delivers compliance training curricula that are focused on the essential elements of the compliance program Collaborate with colleagues and stakeholders to draft and deliver presentations related to compliance and ethics program work and priorities, risks, and metrics May manage major/complex projects involving delegation of work and review of work products

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (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. Job Summary The Provider Data Services Program Manager II leads organizes and coordinates support for Cactus data remediation in various projects, including data remediation efforts through the Symphony Utility, Data Standardized Provider Format (SPF) submissions, Data Governance Clean-Up, and Customer Relationship Management (CRM) special projects. The Program Manager II represents Provider Data Services Department and leads streamlining auditing areas of compliance. This position supports the Director of Credentialing and Data Management through oversight of all data remediation in Cactus. This position primary duties shall include collaboration with the Appeals and Grievances Department and leading the re-development of a compliant process that monitors provider complaints in L.A. Care's network. This position is the business lead for provider data reports required for Credentialing compliance with regulatory audits. The Provider Data Services Program Manager II also leads Cactus provider data remediation efforts through Symphony, Data Governance, and Standardized Provider Format (SPF) submissions. Additionally, this role manages Cactus Imports and Exports modules, manages implementation of upgrades to Cactus modules, and manages inputs or outputs in the Cactus environment that supports Information Technology (I.T.) and Product. This position acts as the Business Lead for Credentialing data reporting, resolves complex problems, and works with moderate guidance and direction from the Senior Director. This individual also initiates and develops strong interpersonal relationships with both internal L.A. Care staff and external business partners in order to facilitate joint decision-making and successful program implementation to support delivery of timely and accurate data remediation through Cactus. Duties Formulate and propose recommended solutions/ options to address moderately complex operational and programmatic challenges with Cactus provider data remediation, with moderate guidance from Senior Director. Assume ownership of data remediation initiatives for Cactus, under direction of Senior Director, for successful development, planning, and execution of programs, data reporting, analysis and improvements to infrastructure, from initial concept to implementation stage, with moderate guidance and supervision from Senior Director. Represent Cactus database interests and initiate engagement of existing internal and external business partners colleagues, to jointly problem-solve complex member and provider issues. Facilitate constructive dialogue among internal and external stakeholders to ensure problems are properly assessed, analyzed and resolved, with moderate guidance and supervision from Senior Director. In concert with other departments, work to draft work plans, policies and procedures that define business needs for Cactus data remediation, including , scope, key milestones and tasks necessary to guide the implementation of new program initiatives, such as Target State, Data Governance, and development of an Appeals & Grievances process for the Direct Network. Maintain work plan updates to capture any changes that arise throughout from each initiative, ensuring Cactus alignment with downstream business processes across the organization. Manage progress and performance as it relates to Cactus tasks; track and report on program status. Identify issues that must be escalated in order to ensure timely completion of program. Manage internal and external meetings, including the development of agendas and objectives. Propose solutions to address and mitigate any anticipated program delays and steer program in positive direction. Execute workflow processes developed by Provider Data Services (PDS) Director for Appeals and Grievances processes; ensure oversight monitoring process in place. Lead oversight and monitoring of Credentialing provider data reports for regulatory audits. Serve as L.A. Care business program lead in external stakeholder meetings on behalf of the Provider Data Management team, as required. Serve as L.A. Care business program lead and actively participate in L.A. Care committee standing meetings and management meetings on behalf of the Provider Data Services team, as required with moderate guidance and supervision from Senior Director. Perform other duties as assigned. Duties Continued Education Required Bachelor's Degree In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree Experience Required: At least 5 years of credentialing auditing experience in a managed care or hospital setting. Proven experience conducting root-cause analyses, policy requirements, and managing highly visible organizational programs. Experience building relationships with organizations and business partners. Preferred: Experience working with managing programs or other managerial experience. Managed care experience. Skills Required: Strong knowledge of NCQA Credentialing Standards, CMS and DHCS regulatory requirements. Strong knowledge of Symplr Cactus database systems. Knowledge of metric management methodology. 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. Proven knowledge of data entry and reporting management within Symplr Cactus database. Licenses/Certifications Required Licenses/Certifications Preferred Certified Provider Credentialing Specialist (CPCS) Project Management Professional (PMP) Required Training Physical Requirements Light Additional 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Data Entry, Relationship Manager, Administrative, Customer Service

Your Role The Appeals and Grievances team helps our members with their concerns, ensures compliance and supports audit activity. The Program Manager, Principal will report to the Sr. Director of Grievances and Appeals. In this role you will support the systems and system changes leveraged by the Appeals and Grievances team, and ensure the implementation, testing, changes and oversight (including vendor oversight) of behavioral health care is managed effectively. You will also be responsible for supporting compliance, regulatory audit activity, inventory management, addressing drivers of inventory, and vendor oversight impacting behavioral health. Your Knowledge and Experience Requires a bachelor's degree or equivalent experience Requires at least 10 years of prior relevant experience Requires at least 5 years Appeals and Grievances experience Behavioral health knowledge and experience preferred, including behavioral health provider type and service knowledge, professional and facility and Applied Behavioral Analysis (ABA) and across all commercial and government lines of business Requires experience in Appeals and Grievance system change, implementation and vendor oversight Requires advanced experience in risk mitigation, problem solving and analysis as well as preparing and presenting related materials Your Work In this role, you will: Operate at a strategic business level to ensure projects/programs impacting behavioral health are in line with Blue Shield of California strategic goals Consult with all levels including senior management, make recommendations, and influence decision-making Leverage cross-functional internal and external relationships to drive behavioral health initiatives forward Plan and implement multiple and extremely complex projects/programs spanning across business areas Determine key business issues impacting behavioral health, develop effective action plans and implement to successful conclusion Lead and document internal/external meetings Facilitate monthly system testing Address current and future state needs Conduct meetings and oversight of vendors Support transformation activity Support compliance and regulatory audit activity impacting behavioral health Support inventory management and address root cause analysis of inventory fluctuations

Your Role The Clinical Program Manager, Principal in collaboration with the Regional Medical Director and the CMO Team for Commercial Business will be responsible for collaborating with all internal stakeholders and externally facing partners to transform the way health care is delivered, ensuring best-in-class care for all members. Priority is given to delivering on the Quadruple Aim (lower cost care, increased quality, increased member satisfaction and physician satisfaction) with a focus on execution to drive and accelerate improvements in primary care for all patients. This role will report to the Regional Medical Director. Your Knowledge and Experience Requires a current, active California RN, NP, or PA license Requires a bachelor's degree; advanced degree is preferred Requires a minimum of 10 years of prior relevant clinical or job related experience Requires previous health plan experience with understanding of Accountable Care Organizations (ACO), global versus shared risk financial arrangements, quality metrics and member experience. Experience in case utilization and utilization management and managed care delegated models is a plus. In-depth understanding of data analytics with mastery of excel and an ability to use multiple data platforms for internal and external communication. Strong PowerPoint application skills to create executive summaries and presentation decks. Excellent verbal and written communication style to drive positive outcomes Ability to be resourceful and collaborative; a team collaborator with strong listening skills and the ability to offer creative solutions to drive consensus Your work In this role, you will: Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of California's strategic goals Consult with all levels (including senior management) making recommendations and influencing decision-making Leverage cross-functional internal and external relationships to drive initiatives forward Plan and implement multiple and extremely complex projects/programs spanning across business areas Determine key business issues, develop effective action plans, and implement to successful conclusion Perform data analysis for all lines of business: Analyze data in collaboration with Regional Medical Director for trends, drivers, and key initiatives. Incorporate the analysis into meaningful discussions with Group/IPA Identify opportunities around utilization, quality, and clinical initiatives: Work side by side with internal and external partners in the design and launch of clinical programs focused on high-risk members, hospital initiatives, and behavioral health as well as internal innovation programs Partner with medical groups to co-create programs encompassing a full spectrum of initiatives around disease management, complex care management, transitions of care and site of service, ensuring optimal utilization, access, and quality of care for members Lead with a collaborative approach and an understanding of existing resources and relationships between/among partner organizations while moving them towards constructive change Work cross functionally with Blue Shield of California internal teams to provide support both ad hoc and for recurrent initiatives

Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (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. Job Summary The Enterprise Risk Adjustment and Encounters Program Manager (PM) II oversees one or more programs ensuring that the department management and key stakeholders define the program goals. This position oversees and administers all phases of programs from inception to finish such as Risk Adjustment and Encounter-related programs for Medicare, Medi-Cal and Commercial lines of business, California Advancing and Innovating Medi-Cal (CalAIM) Programs, Directed Payment Programs, Subcontractor Medical Loss Ratio (MLR), Prop 56/Targeted Rate Increase (TRI), and other programs at the discretion of the leadership team. This position implements work scope, oversees funding, provides program/project planning, and administration. Develops operational policies and procedures. This position works closely with cross-functional teams to conceptualize solutions, organize and align teams for data regression testing, track and monitor system test cases, and user acceptance deliveries and drive towards meeting risk adjustment key performance indicator (KPI) metrics and reports for all three lines of business (Commercial, Medicare and Medi-Cal). The PM II standardizes technical meetings and data discussions. This position sets accountability by tracking progress, resolving dependencies, identifying issues, evaluating risks, and communicating with cross-functional stakeholders to ensure an efficient and consistent execution. The PM II engages the team to continue to support, test and upgrade multi-functional software programs for risk adjustment data collection and processing. The PM II executes the high-impact risk adjustment and encounters system implementations to continuously improve data and reporting processes. This position ensures to increase the effectiveness of encounter data operations, risk adjustment programs and operations infrastructure. The PM II also serves as the program manager for committees. This position is responsible for developing program assessment protocols for effectiveness and quality improvement. The PM II maintains the program standards of quality and performance. This position oversees the program budget for maximum utilization of resources. Duties Oversee cross-program activities and ensure the programs achieve their goals. Formulate, organize and monitor inter-connected programs. Develop and control deadlines and activities. Monitor and evaluate Key Performance Indicator (KPI) and return on investment (ROI). Support cost accounting activities and collaboration with other stakeholders as necessary. Provide guidance to staff. Partner with stakeholders to drive program initiatives improving operating performance such as yield improvements and labor efficiency, balance sheet optimization, and total cost reductions. Direct all phases of programs from inception through completion. Set priorities and milestones for individual projects and team initiatives within the program. Support the implementation and maintenance of internal procedures, policies, and practices to ensure proper safeguarding of L.A. Care's assets. Develop and implement annual work plans; ensure timely and high-quality reviews and submissions of deliverables; prepare scopes of work and monitor service delivery. Participate and recommend in setting program goals and objectives. Ensure team members have the resources needed to meet their goals. Review, edit, and contribute to technical deliverables and manage field assignments as required. Provide recommendations on financial management of assigned programs including developing, tracking, and updating budgets; monitoring monthly projections and actuals; obligated funds notifications; anticipate budget modifications and other financial matters. Plan, develop, and implement strategies for generating funding and/or resource opportunities for program activities. Provide program management and partnership with technical project team. Communicate and document concise program timelines, risks, escalation path, roles/responsibilities, and accountabilities. Facilitate technical meetings for risk adjustment for all product lines, capturing notes and action plans. Synchronize the work of cross-functional project teams and provides direct or indirect oversight scope of work. Evaluate and oversee the development and implementation of Centers for Medicare and Medicaid Services (CMS) and Department of Health Care Services (DHCS) risk adjustment program changes; incorporate changes and requirements into strategy. Duties Continued Develop and manage risk adjustment data infrastructure programs and manage deliveries from beginning to end coordinating with internal teams. Ensure program objectives and deliverables are in alignment with department and L.A. Care goals. Develop program initiative timelines, goals and ensures everything is on schedule and within stated budgets. Serve as a liaison between all I.T. teams to ensure alignment with program goal(s). Develop and manage detailed program t plans, timelines, and deliverables across multiple program activities and risk adjustment initiatives. Provide program coordination with internal risk adjustment functional teams to ensure alignment and progress/completion of program/initiative deliverables. Utilize a client relationship management (CRM) or another system to organize information and facilitate outreach communications, perform forecasting, and measure the performance of programs. Collaborate with key stakeholders on program implementation and facilitate communications with cross-functional departments on the status of ongoing activities, manage compliance to scope and reporting requirements. Obtain approvals from management. Partner with key stakeholders to develop communication, test, training, risk management/mitigation plans, and plan of record. Monitor inter-connected programs/project work product, outcome and interplay to be able to make necessary enhancements or modifications as appropriate to ensure alignment with department objectives. Coordinate cross-program/project activities as necessary. Formulate, organize and coordinate inter-connected programs in encounter and supplemental data collections, system processes, develop and maintain Standards of Operations (SOPs), retrieval and coding vendor platforms workflows, and update regulatory data submissions for risk adjustment data management and methodologies for all three product lines. Create and manage the Participating Provider Groups (PPGs) related to provider educational webinar presentation decks. Manage PPGs Risk Adjustment meeting agendas, minutes, and deliverables for various risk adjustment programs and initiatives. Track and identify trends across various risk adjustment programs and initiatives for continuous process improvement opportunities and to set up best practices to coordinate with PPGs to close care gaps. Identify issues determined to affect risk adjustment and collaborate with the affected teams to resolve those issues that comply with internal and external governing rules and regulations. Develop and distribute reports for senior leaders as it relates to risk adjustment metrics and performance. Assess program performance and aim to maximize ROI, utilize change management strategies to implement enhancements and process improvements as necessary. Navigate and create reports that monitor KPIs. Ensure the accuracy and timeliness of report and data given to key stakeholders. Monitor program operations for quality, efficiency, and effectiveness. May work with vendors, consultants and government agencies that may include vendor management responsibilities. Perform other duties assigned. Education Required Bachelor's Degree in Data Analytics or Related Field In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Data Analytics or Related Field Experience Required: At least 4 years of experience in handling encounter data and/or risk adjustment programs or projects. At least 4 years of work experience performing problem solving, policy, and/or program implementation. Experience with Process Improvement Methodology including defining and documenting workflow. Experience with Workflow Tools - JIRA, Data Lake, Project Server etc. Technical program experience in large distributed systems, complex competing environments, Micro services Architecture, Cloud computing etc. Experience resolving effective program critical metrics and using them to measure program success and identify issues. Experience in program management tools and knowledge of both Agile and Waterfall methodologies and ability to apply them when best suited. Preferred: At least 5 years of experience in Health Care and Managed Care. Experience in finance management. Skills Required: Strong strategic mindset. Excellent verbal, written communication and presentation skills. Excellent problem-solving skills with the ability to identify research and make decisions. Ability to work closely and skillfully with all stakeholders across the organization. Strong organizational, analytical and truth-seeking mentality skills to juggle many tasks without losing sight of the highest priority or roadmap projects. Excellent skills in identifying process gaps, measuring progress, efficiency and balancing with process overhead and exceptional at facilitating discussions. Proven technical capability and an understanding of technical designs, challenges, and risks. Ability to influence, motivate, and align people across a broad variety of job functions through program management skills. Basic understanding of IT driven technologies and Architectures. Working knowledge of SQL Server, Visual Studio, Oracle, MS Office, Visio, Project Server & Jira Management. Ability to articulate and communicate effectively and follow the program management Systems Development Life Cycle (SDLC) lifecycles. Ability to be an effective, collaborative partner with internal and external stakeholders. Understanding of encounter and supplemental data collections, system processes, and regulatory data submissions for risk adjustment data management and methodologies for all product lines. Understanding of end-to-end encounters/claims, supplemental, and risk adjustment data software systems. Ability to lead cross functional internal teams to execute on complex tasks. Critical thinking, program planning and implementation skills. Ability to synthesize and analyze qualitative and/or quantitative data. Knowledge of health care operations or health care systems. Licenses/Certifications Required Licenses/Certifications Preferred Certificate in Program Management Program Management Professional (PgMP) Certification in Project Management Professional Required Training Physical Requirements Light Additional 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles Job Segment: Accounting, Medicare, Medicaid, Claims, Risk Management, Finance, Healthcare, Insurance

Your Role The Clinical Program Manager, Principal in collaboration with the Regional Medical Director and the CMO Team for Commercial Business will be responsible for collaborating with all internal stakeholders and externally facing partners to transform the way health care is delivered, ensuring best-in-class care for all members. Priority is given to delivering on the Quadruple Aim (lower cost care, increased quality, increased member satisfaction and physician satisfaction) with a focus on execution to drive and accelerate improvements in primary care for all patients. This role will report to the Regional Medical Director. Your Knowledge and Experience Requires a current, active California RN, NP, or PA license Requires a bachelor's degree; advanced degree is preferred Requires a minimum of 10 years of prior relevant clinical or job related experience Requires previous health plan experience with understanding of Accountable Care Organizations (ACO), global versus shared risk financial arrangements, quality metrics and member experience. Experience in case utilization and utilization management and managed care delegated models is a plus. In-depth understanding of data analytics with mastery of excel and an ability to use multiple data platforms for internal and external communication. Strong PowerPoint application skills to create executive summaries and presentation decks. Excellent verbal and written communication style to drive positive outcomes Ability to be resourceful and collaborative; a team collaborator with strong listening skills and the ability to offer creative solutions to drive consensus. Your work: In this role, you will: Operate at a strategic business level to ensure projects/programs are in line with Blue Shield of California's strategic goals Consult with all levels (including senior management) making recommendations and influencing decision-making Leverage cross-functional internal and external relationships to drive initiatives forward Plan and implement multiple and extremely complex projects/programs spanning across business areas Determine key business issues, develop effective action plans, and implement to successful conclusion Perform data analysis for all lines of business: Analyze data in collaboration with Regional Medical Director for trends, drivers, and key initiatives. Incorporate the analysis into meaningful discussions with Group/IPA Identify opportunities around utilization, quality, and clinical initiatives: Work side by side with internal and external partners in the design and launch of clinical programs focused on high-risk members, hospital initiatives, and behavioral health as well as internal innovation programs Partner with medical groups to co-create programs encompassing a full spectrum of initiatives around disease management, complex care management, transitions of care and site of service, ensuring optimal utilization, access, and quality of care for members Lead with a collaborative approach and an understanding of existing resources and relationships between/among partner organizations while moving them towards constructive change Work cross functionally with Blue Shield of California internal teams to provide support both ad hoc and for recurrent initiatives

Salary Range: $117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (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. Job Summary The Enterprise Project Manager III is responsible for managing high priority and complex projects across the enterprise. The position is responsible for managing projects across the strategic priorities as well as programs across the business. This position integrates advanced project management practices with high-level analytical capabilities to ensure that initiatives are delivered on time, within scope and budget, and with measurable impact. The Project Manager III interfaces with all areas affected by the project, including end users, distributors, and vendors. This position partners with leadership and cross-functional teams to plan, execute, and evaluate projects to improve operational efficiency, regulatory compliance, and organizational performance. The Project Manager III applies both strategic insight and tactical execution skills to drive data-informed decision-making and deliver organizational value. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Duties Manage the planning, execution, and delivery of projects across diverse business areas, including operational, clinical, strategic, and technology initiatives. Define project scope, goals, deliverables, timelines, and success metrics in collaboration with sponsors and stakeholders. Conduct high-level data and process analysis to inform project design, evaluate outcomes, and identify opportunities for improvement. Develop detailed project plans, schedules, budgets, and resource allocations. Monitor progress against milestones, manage risks, issues, and dependencies, and implement mitigation strategies. Prepare and present project updates, dashboards, and analytical reports to leadership and governance bodies. Facilitate cross-functional collaboration to ensure alignment and communication across departments. Ensure project compliance with legislation and organizational policies, procedures, and managed care regulatory requirements. Support post-implementation evaluation, including benefits realization, lessons learned, and continuous improvement. Mentor and guide project teams and business partners in project management and analytical best practices. Track maintenance of business needs and requirements. Develop detailed project plans, schedules, budgets, and resource allocations. Duties Continued Facilitate project meetings, status reports, and communications with cross-functional teams. Distribute project communication artifacts such as charter, budgets routinely to management, project team members, and other key stakeholders, actively soliciting and addresses feedback. Partner with key stakeholders to monitor budgets, forecast resource needs, and track key performance indicators. Ensure project documentation is maintained according to Project Management Office (PMO) standards and audit requirements. Collaborate with key stakeholders to coordinate implementation and sustainment activities. Apply subject expertise in evaluating business operations and processes. Identify areas where technical solutions would improve business performance. Consult across business operations, provide mentorship, and contribute specialized knowledge. Ensure that the facts and details are correct so that the projects meets the needs of the department, organization and legislation's policies, standards, and best practices. Provide training, recommend process improvements, and mentor junior level staff, department interns, etc. as needed. Performs other duties as assigned. Education Required Bachelor's Degree in Business Administration or Related Field In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Business Administration or Related Field Experience Required: At least 5 years of progressive experience in project management, business analysis, or operations management within a healthcare or managed care organization. At least 4 years of moderate to complex project management experience. Experience working simultaneously on multiple projects. Experience and knowledge with different project management frameworks, including waterfall and agile. Proven experience leading complex, cross-functional projects involving multiple stakeholders. Strong experience in data and process analysis, performance measurement, and reporting. Preferred: Experience in regulatory compliance Experience managing project budgets. Skills Required: Advanced project management skills, including knowledge of Agile, Waterfall, and hybrid methodologies. Ability to build strong relationships and communicate effectively with internal and external stakeholders. Strong grasp of current communication, project tracking, and budget management technologies. Excellent facilitation skills, with proven knowledge of how to foster attendee participation and collaboration in small and large groups. Solid technical understanding and ability to define and refine requirements through a project lifecycle. Strong problem-solving skills to manage shifting priorities, demands and timelines. Strong analytical and critical thinking skills, with ability to interpret complex data and translate insights into actionable recommendations. Proficiency in project management and analytics tools (e.g., MS Project, Smartsheet, Jira, Power BI, Tableau, Excel). Excellent written and verbal communication skills, including executive-level reporting and presentations. Strong organizational, facilitation, and stakeholder management skills. Ability to build relationships and influence cross-functional teams and leadership. Deep understanding of managed care operations, quality improvement, and regulatory compliance. Adaptability and resilience in managing complex, fast-paced initiatives. Demonstrated ability to manage competing priorities and deliver results in a matrixed environment. Preferred: Knowledge of vendor management. Ability to understand healthcare or managed care landscape. Licenses/Certifications Required Licenses/Certifications Preferred Agile or Scrum certification (e.g., Certified ScrumMaster) Lean Six Sigma Green Belt Project Management Certificate Project Management Professional (PMP) Program Management Professional (PgMP) Required Training Physical Requirements Light Additional 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles

Salary Range: $117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (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. Job Summary The Enterprise Project Manager III is responsible for managing high priority and complex projects across the enterprise. The position is responsible for managing projects across the strategic priorities as well as programs across the business. This position integrates advanced project management practices with high-level analytical capabilities to ensure that initiatives are delivered on time, within scope and budget, and with measurable impact. The Project Manager III interfaces with all areas affected by the project, including end users, distributors, and vendors. This position partners with leadership and cross-functional teams to plan, execute, and evaluate projects to improve operational efficiency, regulatory compliance, and organizational performance. The Project Manager III applies both strategic insight and tactical execution skills to drive data-informed decision-making and deliver organizational value. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Duties Manage the planning, execution, and delivery of projects across diverse business areas, including operational, clinical, strategic, and technology initiatives. Define project scope, goals, deliverables, timelines, and success metrics in collaboration with sponsors and stakeholders. Conduct high-level data and process analysis to inform project design, evaluate outcomes, and identify opportunities for improvement. Develop detailed project plans, schedules, budgets, and resource allocations. Monitor progress against milestones, manage risks, issues, and dependencies, and implement mitigation strategies. Prepare and present project updates, dashboards, and analytical reports to leadership and governance bodies. Facilitate cross-functional collaboration to ensure alignment and communication across departments. Ensure project compliance with legislation and organizational policies, procedures, and managed care regulatory requirements. Support post-implementation evaluation, including benefits realization, lessons learned, and continuous improvement. Mentor and guide project teams and business partners in project management and analytical best practices. Track maintenance of business needs and requirements. Develop detailed project plans, schedules, budgets, and resource allocations. Duties Continued Facilitate project meetings, status reports, and communications with cross-functional teams. Distribute project communication artifacts such as charter, budgets routinely to management, project team members, and other key stakeholders, actively soliciting and addresses feedback. Partner with key stakeholders to monitor budgets, forecast resource needs, and track key performance indicators. Ensure project documentation is maintained according to Project Management Office (PMO) standards and audit requirements. Collaborate with key stakeholders to coordinate implementation and sustainment activities. Apply subject expertise in evaluating business operations and processes. Identify areas where technical solutions would improve business performance. Consult across business operations, provide mentorship, and contribute specialized knowledge. Ensure that the facts and details are correct so that the projects meets the needs of the department, organization and legislation's policies, standards, and best practices. Provide training, recommend process improvements, and mentor junior level staff, department interns, etc. as needed. Performs other duties as assigned. Education Required Bachelor's Degree in Business Administration or Related Field In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Business Administration or Related Field Experience Required: At least 6 years of progressive experience in project management, business analysis, or operations management within a healthcare or managed care organization. At least 4 years of moderate to complex project management experience. Experience working simultaneously on multiple projects. Experience and knowledge with different project management frameworks, including waterfall and agile. Proven experience leading complex, cross-functional projects involving multiple stakeholders. Strong experience in data and process analysis, performance measurement, and reporting. Preferred: Experience in regulatory compliance Experience managing project budgets. Skills Required: Advanced project management skills, including knowledge of Agile, Waterfall, and hybrid methodologies. Ability to build strong relationships and communicate effectively with internal and external stakeholders. Strong grasp of current communication, project tracking, and budget management technologies. Excellent facilitation skills, with proven knowledge of how to foster attendee participation and collaboration in small and large groups. Solid technical understanding and ability to define and refine requirements through a project lifecycle. Strong problem-solving skills to manage shifting priorities, demands and timelines. Strong analytical and critical thinking skills, with ability to interpret complex data and translate insights into actionable recommendations. Proficiency in project management and analytics tools (e.g., MS Project, Smartsheet, Jira, Power BI, Tableau, Excel). Excellent written and verbal communication skills, including executive-level reporting and presentations. Strong organizational, facilitation, and stakeholder management skills. Ability to build relationships and influence cross-functional teams and leadership. Deep understanding of managed care operations, quality improvement, and regulatory compliance. Adaptability and resilience in managing complex, fast-paced initiatives. Demonstrated ability to manage competing priorities and deliver results in a matrixed environment. Preferred: Knowledge of vendor management. Ability to understand healthcare or managed care landscape. Licenses/Certifications Required Licenses/Certifications Preferred Agile or Scrum certification (e.g., Certified ScrumMaster) Lean Six Sigma Green Belt Project Management Certificate Project Management Professional (PMP) Program Management Professional (PgMP) Required Training Physical Requirements Light Additional 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles

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. Job Summary The Enterprise Project Manager III is responsible for managing high priority and complex projects across the enterprise. The position is responsible for managing projects across the strategic priorities as well as programs across the business. This position integrates advanced project management practices with high-level analytical capabilities to ensure that initiatives are delivered on time, within scope and budget, and with measurable impact. The Project Manager III interfaces with all areas affected by the project, including end users, distributors, and vendors. This position partners with leadership and cross-functional teams to plan, execute, and evaluate projects to improve operational efficiency, regulatory compliance, and organizational performance. The Project Manager III applies both strategic insight and tactical execution skills to drive data-informed decision-making and deliver organizational value. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Duties Manage the planning, execution, and delivery of projects across diverse business areas, including operational, clinical, strategic, and technology initiatives. Define project scope, goals, deliverables, timelines, and success metrics in collaboration with sponsors and stakeholders. Conduct high-level data and process analysis to inform project design, evaluate outcomes, and identify opportunities for improvement. Develop detailed project plans, schedules, budgets, and resource allocations. Monitor progress against milestones, manage risks, issues, and dependencies, and implement mitigation strategies. Prepare and present project updates, dashboards, and analytical reports to leadership and governance bodies. Facilitate cross-functional collaboration to ensure alignment and communication across departments. Ensure project compliance with legislation and organizational policies, procedures, and managed care regulatory requirements. Support post-implementation evaluation, including benefits realization, lessons learned, and continuous improvement. Mentor and guide project teams and business partners in project management and analytical best practices. Track maintenance of business needs and requirements. Develop detailed project plans, schedules, budgets, and resource allocations. Duties Continued Facilitate project meetings, status reports, and communications with cross-functional teams. Distribute project communication artifacts such as charter, budgets routinely to management, project team members, and other key stakeholders, actively soliciting and addresses feedback. Partner with key stakeholders to monitor budgets, forecast resource needs, and track key performance indicators. Ensure project documentation is maintained according to Project Management Office (PMO) standards and audit requirements. Collaborate with key stakeholders to coordinate implementation and sustainment activities. Apply subject expertise in evaluating business operations and processes. Identify areas where technical solutions would improve business performance. Consult across business operations, provide mentorship, and contribute specialized knowledge. Ensure that the facts and details are correct so that the projects meets the needs of the department, organization and legislation's policies, standards, and best practices. Provide training, recommend process improvements, and mentor junior level staff, department interns, etc. as needed. Performs other duties as assigned. Education Required Bachelor's Degree in Business Administration or Related Field In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Master's Degree in Business Administration or Related Field Experience Required: At least 5 years of progressive experience in project management, business analysis, or operations management within a healthcare or managed care organization. At least 4 years of moderate to complex project management experience. Experience working simultaneously on multiple projects. Experience and knowledge with different project management frameworks, including waterfall and agile. Proven experience leading complex, cross-functional projects involving multiple stakeholders. Strong experience in data and process analysis, performance measurement, and reporting. Preferred: Experience in regulatory compliance Experience managing project budgets. Skills Required: Advanced project management skills, including knowledge of Agile, Waterfall, and hybrid methodologies. Ability to build strong relationships and communicate effectively with internal and external stakeholders. Strong grasp of current communication, project tracking, and budget management technologies. Excellent facilitation skills, with proven knowledge of how to foster attendee participation and collaboration in small and large groups. Solid technical understanding and ability to define and refine requirements through a project lifecycle. Strong problem-solving skills to manage shifting priorities, demands and timelines. Strong analytical and critical thinking skills, with ability to interpret complex data and translate insights into actionable recommendations. Proficiency in project management and analytics tools (e.g., MS Project, Smartsheet, Jira, Power BI, Tableau, Excel). Excellent written and verbal communication skills, including executive-level reporting and presentations. Strong organizational, facilitation, and stakeholder management skills. Ability to build relationships and influence cross-functional teams and leadership. Deep understanding of managed care operations, quality improvement, and regulatory compliance. Adaptability and resilience in managing complex, fast-paced initiatives. Demonstrated ability to manage competing priorities and deliver results in a matrixed environment. Preferred: Knowledge of vendor management. Ability to understand healthcare or managed care landscape. Licenses/Certifications Required Licenses/Certifications Preferred Agile or Scrum certification (e.g., Certified ScrumMaster) Lean Six Sigma Green Belt Project Management Certificate Project Management Professional (PMP) Program Management Professional (PgMP) Required Training Physical Requirements Light Additional 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 Reimbursement * Retirement Plans * Medical, Dental and Vision * Wellness Program * Volunteer Time Off (VTO) Nearest Major Market: Los Angeles