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Director Premium Billing and Member Enrollment (Director II) CalOptima Join Us - Where Your Talent Meets Opportunity. We're Better Together 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 Director Premium Billing and Member Enrollment (Director II) and help shape the future of healthcare where you'll be an integral part of our Operations Management 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. CalOptima Health is looking for a strategic thinker with a proven track record of leading a high-performing team to establish and manage the Enrollment and Billing function related to Health Insurance Exchange/Marketplace/Covered California product operations. As the Director, you'll serve in a leadership role to define and scale up their own team, roadmap, implement, and manage operationalization of this capability at CalOptima Health, and drive closing the people, process, and technological gaps between current state and future state operations to support enrollment and billing capabilities for the Covered California line of business. This role will be critical in standing up and continuing to successfully execute seamless enrollment, accurate billing, and regulatory compliance for the product line expansion. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>45% - Leadership Functions
<ul>
<li>Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>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.</li>
<li>Directs, hires and trains department managers and staff.</li>
<li>Reviews and develops the performance of department staff and sets monthly or quarterly goals.</li>
<li>Serves as the key point of contact and advisor for executive leadership when making strategic decisions impacting the operations of the Enrollment and Billing function at CalOptima Health.</li>
<li>Develops and executes the 12-18-month roadmap to operationalize Enrollment and Billing capabilities for Covered California line of business - integrating with existing Medi-Cal workflows (where applicable), defining new operational processes, and configuring existing and/or new systems to support Covered California line of business.</li>
<li>Builds out and leads Enrollment and Billing function at CalOptima Health (i.e., recruiting, coaching, and retaining team, setting up governance structure, collaborating cross-functionally with other CalOptima Health functions to identify teams' dependencies, etc.).</li>
<li>Oversees the timely and accurate completion of Covered California enrollment capabilities inclusive of ingestion and processing of 834 enrollment files, plan changes, cancellations, and grace-period management per Covered California rules. </li>
</ul>
</li>
<li>50% - Program Oversight
<ul>
<li>Implements and oversees end-to-end premium billing capability -including invoice generation, member payments, financial reconciliation (including subsidies) and refunds-ensuring regulatory compliance.</li>
<li>Reconciles membership and premium data with Covered California and internally at CalOptima Health to support regulatory requirements and data accuracy internally on a cyclical basis.</li>
<li>Manages the end-to-end enrollment and billing processing and reconciliation for the off-exchange population.</li>
<li>Oversees integration and management of the enrollment and billing capabilities that third party vendors and delegated health network are responsible and accountable for.</li>
<li>Leads vendor and technology selection for vended capabilities and oversees implementation and integration with the organization's processes and technologies.</li>
<li>Leads the development of processes and configuration of core admin system to support implementation and ongoing optimization of the premium billing capability at CalOptima - inclusive of partnering with CalOptima Health's Information Technology teams (and potentially vendor teams), overseeing system and data integrations, etc.</li>
<li>Develops and manages the annual departmental budget. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned.</li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree in business, health administration, finance, or related field PLUS 7 years in health-plan operations with at least 5 years in health insurance exchange/marketplace and/or commercial Individual and Family Plan (IFP) enrollment and billing required; 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. </li>
<li>3 years of progressive management/leadership experience required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Knowledge and prior experience at a health plan leading enrollment and billing functions for an exchange or commercial product. </li>
<li>Specific experience with Covered California.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>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. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>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.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 321 - $181,257 - $290,011 ($87.14 - $139.4282). 
<ul>
<li>The base pay offered will take into account internal equity and also may vary depending on the candidate's job-related knowledge, skills, and experience among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Office </li>
</ul>
 A <a href="https://apptrkr.com/get_redirect.php?id=6824863&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> 
<ul>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 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 October 13, 2025 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 committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. 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: <a href="https://apptrkr.com/6824863" target="_blank">https://jobs.caloptima.org/jobs/director-premium-billing-and-member-enrollment-director-ii-505-city-parkway-west-california-united-states-ee0bc9cf-38a1-4124-be64-0b430f44db76</a> Copyright 2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-facf3ef77d8102469ba67f2032a32789

Director Premium Billing and Member Enrollment (Director II)

Corporate Action Analyst- New York, NY- Collab w/ counterparties to settle corp. action proceeds from fails &amp; stock loan borrow contracts, mng &amp; comm risk arnd events &amp; liaise w/ our Algo, Compliance, &amp; Ops teams to opt processes. Admin, test, &amp; implmnt corp. action databases, applying knwldg of database mngmnt sys &amp; data analysis. Implmnt enhncmnts to posttrad pltfrms &amp; databases utilizing Linux op system. Utilize distrbtd, scalable analytical tools &amp; distrbtn sys to supp posttrade reporting &amp; integration of trading data. Apply stat &amp; fin engg technqs to analyze posttrade data &amp; utilize SQL &amp; rel databases to identify issues &amp; perf root cause analysis on prob corp. action processing to increase atmtn. Utilize risk mngmnt sys &amp; fin models to analyze corp. action events from external data sources while verifying the tech &amp; math accuracy of data. Identify &amp; rvw stock &amp; cash reconcltn discreps, &amp; ensure issues properly resolved. Req's: Master's (U.S. or foreign equiv) in Asset Mngmnt, Fin Math, Finance, Stats, or closely rel field, plus 6 mos of exp in the pos offered, Quant Fin Analyst, Trader, US Equity &amp; ETF, or rel exp. All req'd exp must have incldd: analyzing transaction data, settlement risk, clearing, trade reconciliations, securities borrowing &amp; complex lending. developing automation scripts using Python &amp; SQL to monitor trading strategies, daily trade positions &amp; P&amp;L. Exp w/ DTC &amp; OCC portals. debugging queries &amp; scripts to auto operational tasks. Exp w/ Corp. Action &amp; dividend processing. Employer will accept any amt of prof exp with the req'd skills. Salary Range: $140k-185K. To apply: email resume to <a href="mailto:HRTresumes@hudson-trading.com" target="_blank">HRTresumes@hudson-trading.com</a> &amp; ref code in subj line: AL402328.

Corporate Action Analyst

<h3>Job Description</h3>
About this Position
Job Title: Systems Admin
Position Description and Job Skill Set:
Strong Governance and Accountability:
<ul>
<li>Confirms IT practices align with internal policies, governance and regulatory expectations.</li>
<li>Provides objective, third party validation for senior managers, executives and board members.</li>
<li>Reduces conflicts of interest by producing fact- based assessments and where possible win/win outcomes.</li>
</ul>
Legal and Regulatory Risk Reduction:
<ul>
<li>Identifies gaps in compliance with laws and regulations (e.g., data protection, cybersecurity, State and Federal rules).</li>
<li>Helps prevent fines, sanctions, litigation and federal enforcement action from Department of Labor.</li>
<li>Ensure IT controls support legal obligations such as data retention, and breach notifications.</li>
</ul>
Improves Policy Effectiveness Evaluates whether IT policies are:
<ul>
<li>Legally sound.</li>
<li>Up to date with current state and federal laws and standards.</li>
<li>Properly implemented and enforced.</li>
</ul>
Better Decision Making for Leadership:
<ul>
<li>Provides clear, unbiased insight to support strategic decisions.</li>
<li>Translates technical findings into legal and policy implications executives can understand.</li>
<li>Prioritizes remediation based on business, legal and compliance risk - not just technical severity.</li>
<li>Identifies opportunities for organizational improvement through IT best practices adoption.</li>
</ul>
Cost Savings, Avoidance and Mid to Long-Terms Efficiency:
<ul>
<li>Prevents costly remediation after incidents or regulatory findings.</li>
<li>Identifies redundant outdated or non-compliant systems.</li>
<li>Aligns IT Investments with Legal and Policy Priorities.</li>
</ul>
Clear, Actionable Roadmap:
<ul>
<li>Delivers prioritized recommendation spanning:</li>
<li>technical controls.</li>
<li>Policy updates.</li>
<li>Legal compliance.</li>
<li>Help coordinate IT, Legal, compliance and risk teams effectively.</li>
</ul>
 
Required Skills/Experience:
Technical and Domain expertise:
<ul>
<li>Deep knowledge in IT, Finance, HR management.</li>
<li>Ability to Analyze complex problems and design practical yet simple solution.</li>
<li>Industry best practices and regulatory awareness.</li>
<li>Knowledge of Mississippi public sector IT practices and landscape.</li>
</ul>
Analytical and Problem-Solving Skills:
<ul>
<li>Strong data analysis and critical thinking abilities.</li>
<li>Ability to diagnose business, application, and legal challenges and identify root causes.</li>
<li>Experience in developing actionable recommendations.</li>
</ul>
Communication Skills:
<ul>
<li>Excellent written and verbal communication.</li>
<li>Ability to explain complex concepts to non-technical stakeholders.</li>
<li>Strong presentation and reporting skills.</li>
</ul>
Client and Stakeholder Management:
<ul>
<li>Relationship-building and trust management.</li>
<li>Ability to manage client expectations and scope.</li>
<li>Professional negotiation and conflict resolution.</li>
</ul>
Project Management:
<ul>
<li>Planning, executing and delivery of consulting engagements.</li>
<li>Time management and prioritization across multiple stakeholders/clients.</li>
<li>Risk identification and mitigation.</li>
</ul>
Business and Commercial Skills:
<ul>
<li>Proposal writing and contract negotiation.</li>
<li>Budgeting, pricing, financial analysis, and forecasting.</li>
</ul>
Self- Management and Independence:
<ul>
<li>Ability to work autonomously and with minimal supervision.</li>
<li>Strong organizational and decision-making skills.</li>
<li>Accountability for deliverables and outcomes.</li>
</ul>
 
Preferred/Not Required:
<ul>
<li>Bachelor's or Master’s degree.</li>
<li>10 +years working for large consulting company.</li>
<li>10 + years delivering consulting or advisory services 5+ years working for any state agency 10 + years working in an Oversight capacity.</li>
<li>Experience working with the Department of Labor.</li>
<li>Prior experience as a contractor, freelancer of consultant.</li>
</ul>
 
 
"No phone calls please."

Systems Admin

<h3>Job Description</h3>
Job Description*MUST HAVE HANDS ON EXPERIENCE IN AN MSP ENVIRONMENT* System Admin/ IT Consultant (level 3) / Project Management experience We are seeking a highly skilled and experienced Senior Technology Consultant to join our fast paced, constantly changing, dynamic team. The ideal candidate will have previous experience working with Managed Solution Providers. The ideal candidate will have previous experience working indepentdently in the field while troubleshooting or implmenting various technologies - INDEPENTDENTLY. We are a TEAM, but it is important to have the Skills to act Indepentently while in the field troubleshooting. This person will be able to troubleshoot various type of networks for a variety of clients. In this role, you will leverage your expertise in technology solutions to troubleshoot, implment and drive innovation and deliver exceptional results for our clients. The ideal candidate will possess a strong background in technology consulting, with a particular emphasis on LAN/WAN environments and will be Microsoftcentric. Working with LAN/WAN on customer networks is our business, each client could present unique challenges! You will work closely with clients to understand their needs, develop strategic recommendations, and implement solutions that enhance their operational efficiency and competitive advantage - while troubleshooting issues that arise. If you like unpredictablility, keep reading! Duties Collaborate with clients to assess their technology needs and challenges, providing tailored consulting services that align with their business objectives. Design and implement advanced technology solutions, focusing on the Microsoft Platforms. Conduct thorough analyses of existing systems and processes to identify areas for improvement and optimization. Troublehsooting Internet Performance, Firewalls, Servers, Wireless, VoIP and Connectivity Stay abreast of industry trends and emerging technologies, providing thought leadership and strategic insights to clients. Help maintain comprehensive documentation, including project plans, technical specifications.. Work well with our entire team and support others in a mentorship type role while supporting escalated or overflow tickets. Qualifications Bachelor's degree in Computer Science, or a related field; industry certifications a plus. Proven experience as a Technology Consultant or similar role, with a strong focus on Managed Solution Providers. In-depth knowledge of current technology trends and best practices in the industry. Excellent analytical and problem-solving skills, with the ability to think critically and strategically in unique situations. Strong communication skills, both verbal and written, with the ability to convey complex technical concepts to non-technical stakeholders. Demonstrated ability to manage multiple (yet often small in scope) projects simultaneously while maintaining attention to detail. A collaborative mindset with the ability to work effectively in a team-oriented environment.
Active Directory, Business Requirement Document, Microsoft SQL Server, System Analysis, IBM, MSP EXPERIENCE REQUIRED - ONSITE 5 DAYS A WEEK

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