Manager, Strategic Development, Individual and Family Plans - Covered California

Manager, Strategic Development, Individual and Family Plans - Covered California

CalOptima

Join Us in this Amazing Opportunity

The Team You'll Join

We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.

More About the Opportunity

We are hoping you will join us as a Manager, Strategic Development, Individual and Family Plans - Covered California and help shape the future of healthcare where you'll be an integral part of our Strategic Development team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Partial Telework.

• If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.

The Manager of Strategic Development for Individual and Family Plans will be responsible for leading the planning, development, and execution of strategic initiatives that advance department priorities, ensuring effective program design, cross functional collaboration, and alignment with CalOptima Health's long term organizational goals. You will support the implementation and ongoing management of CalOptima Health's new commercial product line, Covered California. You will collaborate with all levels of CalOptima Health staff to integrate programs, develop processes, establish program governance and project structure, set program objectives and implement program requirements while understanding dependencies for ensuring effective and efficient program delivery. You will support program specific strategic planning, process development and operational implementation to meet goals as identified in CalOptima Health's strategic plan, mission, and vision. Together, we are building a stronger, more equitable health system.

Your Contributions To the Team:

• 50% - Leadership Functions
  • Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  • Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department.
  • Monitors performance of the Covered California product, including enrollment trends, member experience, utilization patterns, and key quality measures.
  • Leads planning and implementation of program-specific initiatives through their full life cycle.
  • Drives the long-term product vision by identifying emerging needs, industry trends, and opportunities to enhance Covered California's offerings.
  • Supports strategic planning efforts to define product roadmaps that support organizational goals and future program growth.
  • Partners with cross-functional teams to shape and implement multi-year product strategies that improve member experience and access to care in alignment with broader CalOptima Health strategic plan.
  • Provides overall direction, coordination, implementation, execution, control and completion of tasks supporting new program implementation and process development.
  • Manages employees directly and is responsible for selecting, training, developing, reviewing and setting department and individual performance goals.
  • Encourages professional and personal development and uses regular ongoing training sessions to build relationships, ensure productivity and minimize employee turnover.
  • Manages and coaches teams through documenting initiatives and discussions, identifying gaps/issues/solutions, standardizing tools/templates, implementing quality departmental initiatives and reporting to stakeholders and the management team.
    
    
• 45% - Program Oversight
  • Monitors Covered California policy updates, guidance, and regulatory changes to assess impacts on program and operational processes.
  • Supports the evaluation and implementation of annual benefit design updates, ensuring compliance with state and federal requirements.
  • Tracks marketplace requirements, regulatory changes that impact the program, and engagements with program staff and leadership to ensure ongoing compliance and engagement.
  • Engages with cross-functional workgroups responsible for implementing product design.
  • Reviews benefit language for regulatory filings, evidence of coverage (EOC), summary of benefits and coverage (SBC), and other product documents.
  • Collaborates with staff from across the organization on researching specific operational issues to develop and analyze solutions and make policy or programmatic recommendations for improvement.
  • Develops business and technological tools to enhance and support the implementation of programs and processes.
  • Tracks marketplace requirements, regulatory changes that impact the program, and engagements with program staff and leadership to ensure ongoing compliance and engagement.
  • Stays current on local, state and federal health care environment to identify public policy and market trends that may impact CalOptima Health's programs and/or mission.
  • Supports leadership in all commercial product activities requiring collaboration with CalOptima Health's Board of Directors, staff, members, providers, regulatory agencies, advisory committees and representatives of other agencies.
    
    
• 5% - Completes other projects and duties as assigned.

Do You Have What the Role Requires?

• Bachelor's degree in health services administration, public health, public policy or related field required PLUS 5 years of experience in program and project management required, preferably in new program development or implementation with at least 2 years of prior experience that must have been in government programs at a managed care plan, including Medicaid/Medi-Cal, Medicare, or marketplace/commercial plans; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
  
• 3 years of experience working with process improvement, strategic planning or program evaluation and reporting required.

You'll Stand Out More If You Possess the Following:

• Experience interfacing with local, state or federal regulators.
  
• Experience in marketplace/commercial regulatory filings.
  
• 2 years of lead or supervisory experience.

What the Regulatory Agencies Need You to Possess?

• n/a

Your Knowledge & Abilities to Bring to this Role:

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Your Physical Requirements (With or Without Accommodations):

• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment less than 10 pounds

Ways We Are Here For You

• You'll enjoy competitive compensation for this role.
  • Our current hiring range is: Pay Grade: 316 - $120,881 - $193,410 ($58.12 - $92.9856).
    • The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors.
      
      
• This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**)
• A comprehensive benefits package
• CalPERS pension program and additional retirement packages.
• Additional benefits and perks including:
  • A generous PTO program
  • A quality work life balance
  • Various wellness programs
  • Tuition Reimbursement
  • Professional development opportunities
  • Career development opportunities
  • Flexible scheduling
  • And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.

Our Work Environment:

If located at the 500, 505 Building or a remote work location:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• There are no harmful environmental conditions present for this job.
• The noise level in this work environment is usually moderate.

If located at PACE:

• Work is typically indoors in a clinical setting serving the frail and elderly.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

If located in the Community:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• Employee will occasionally work outdoors in varied temperatures.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

Why Join Us?

We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare.

What's Your Next Step?

All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is July 12, 2026 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.

Our Commitment to You

Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview.

If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.

We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process.

CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.


To apply, please visit: https://jobs.caloptima.org/jobs/manager-strategic-development-individual-and-family-plans-covered-california-505-city-parkway-west-california-united-states







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