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Financial Analyst IV (Decision Support) CalOptima CalOptima Health is seeking a highly motivated Financial Analyst IV (Decision Support) to join our team. The Financial Analyst IV (Decision Support) will be responsible for providing analysis, guidance and expert knowledge on health care finance for various departments within CalOptima Health. Working independently, the incumbent will lead large-scale analytical initiatives and develop report suites and financial models used to forecast medical cost trends. The incumbent will provide support for provider contract negotiations, assess actuarial rate development studies, participate in annual budgeting functions, provide ad-hoc analytic support as needed and act as a resource to staff and other consultants within the department. The incumbent will evaluate various complex issues, perform detailed analysis and communicate well reasoned solutions to all levels of management within CalOptima Health. The incumbent will work with large amounts of claims, enrollment and provider data. Position Information: 
<ul>
<li>Department: Financial Analysis </li>
<li>Salary Grade: 314 - $99,902 - $159,843 ($48.03 - $76.8476) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>95% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Researches, assesses and develops advanced tools, models, reports and approaches to increase the accuracy and timeliness of data-driven work projects.</li>
<li>Develops medical expense, revenue and enrollment projections to support the budget process.</li>
<li>Develops financial models and reports to support provider contract negotiations.</li>
<li>Develops return on investment and business case analyses for program initiatives under consideration by management.</li>
<li>Provides clinical and utilization analysis to assist Medical Management with improving outcomes and quality of care for CalOptima Health members.</li>
<li>Collaborates with the Data Warehouse team to design and recommend improvements to the data warehouse.</li>
<li>Provides support and analyses around risk adjustment.</li>
<li>Mentors, trains and serves as a lead for analytical staff.</li>
<li>Designs, develops, implements and maintains report suites and dashboards for all levels of CalOptima Health management.</li>
<li>Serves as a subject matter expert around one or more of the following areas: Medi-Cal provider rate methodology, Medicare provider rate methodology, Department of Health Care Services (DHCS) revenue, Centers for Medicare &amp; Medicaid Services-Medicare Advantage (CMS-MA) revenue, population health member cohort identification, industry standard approaches to health care cost service categorization and metrics. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in business administration, finance, economics, actuarial sciences or related field PLUS 6 years of experience working with health care finance reporting and analytics in a medical group, hospital or health plan setting 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 experience in Provider Contract Modeling required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Experience working with commercial, Medi-Cal and Medicare large payer data sets and related pricing information that is publicly available. </li>
<li>Experience developing annual organizational budgets, forecasts and financial modeling. </li>
<li>Experience using Tableau and/or Microsoft SQL Server.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6299502&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 26, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6299502" target="_blank">https://jobs.caloptima.org/jobs/financial-analyst-iv-decision-support-505-city-parkway-west-california-united-states</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-f3569a1ca984034796c2553e8b161065

Financial Analyst IV (Decision Support)

Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal) CalOptima CalOptima Health is seeking a highly motivated Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal) to join our team. The Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal) will be responsible for assisting with all Hierarchical Condition Categories (HCC) projects and Medi-Cal Annual Wellness Visit Initiative Program. The incumbent will handle risk adjustment-related activities to ensure the Centers for Medicare &amp; Medicaid Services (CMS) and Department of Health Care Services (DHCS) coding and documentation guidelines are met. The incumbent will assist in improving risk score performance through collaboration with CalOptima Health's health networks, contracted providers and Program of All-Inclusive Care for the Elderly (PACE) providers. The incumbent will substantiate and verify the member's medical records using International Classification of Diseases (ICD)-10 Clinical Modification (CM) official guidelines for coding and reporting during the review process. The incumbent will verify the accuracy, completeness and appropriateness of diagnosis codes based on the medical documentation provided. As part of the medical records review, travel may be required to physician offices or physician medical groups throughout Orange County. Position Information: 
<ul>
<li>Department: Financial Analysis </li>
<li>Salary Grade: 309 - $68,015 - $108,824 ($32.70 - $52.3192) </li>
<li>Work Arrangement: Full Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>80% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Reviews and assesses the accuracy, completeness, specificity and appropriateness of diagnosis codes based on documentation and creates tools/tip sheets for audit staff to utilize for future audits based on findings.</li>
<li>Conducts in depth retrospective and prospective medical record audits to assess the accuracy of ICD-10 CM coding for chronic conditions as it pertains to HCC for CalOptima Health Community Network (CHCN), PACE providers and delegated health networks.</li>
<li>Tracks all network HCC activities, including training, audit results and evaluating future outcomes, which includes monitoring performance improvement of network providers by observing patterns and trends and recommending solutions to the manager.</li>
<li>Reviews medical record information to identify all appropriate coding CMS HCC categories and DHCS coding and monitors the DHCS and CMS websites for updates.</li>
<li>Reviews additional data identified from audits to ensure timely data entry for CMS sweeps.</li>
<li>Identifies providers for education and training opportunities following ICD-10-CM coding guidelines based on HCC audit results and Medi-Cal Annual Wellness Visit Initiative Program and reports findings to the Manager.</li>
<li>Assists with CMS Risk Adjustment Data Validation (RADV) and Office of Inspector General (OIG) audits, including workflow or data collection requirements and creating and maintaining HCC audit results when applicable.</li>
<li>Performs code abstraction on supported clinical documentation identified as opportunities through Natural Language Processing (NLP) software. </li>
</ul>
</li>
<li>15% - Administrative Support
<ul>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Assists manager in evaluating existing reports for PACE members provided by CMS and collaborates with Financial Analysis to create any custom report required to assist with audits. </li>
</ul>
</li>
<li>5% - Other-
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in public health, business administration or related field PLUS 5 years of risk adjustment coding and chart audit/quality experience in a managed care or health care environment 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>Have access to means of transportation for work away from the primary office approximately 20% of the time required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Registered Health Information Technician (RHIT) or Certified Risk Adjustment Coder (CRC). </li>
<li>Experience with conducting presentations and performing physician education.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>Current Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) by the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) required. Certification is required to be current and maintained during employment.</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6299515&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 26, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6299515" target="_blank">https://jobs.caloptima.org/jobs/certified-coding-specialist-sr-hcc-medicare-and-medi-cal-505-city-parkway-west-california-united-states</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-d4deeaad9bc4a74cb61631e4900eb19a

Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal)

Supervisor Information Technology Services (Infrastructure) CalOptima CalOptima Health is seeking a highly motivated Supervisor Information Technology Services (Infrastructure) to join our team. The Supervisor Information Technology Services will assist the manager with overseeing technical assistance regarding hardware/software related requests through Information Technology Service Management (ITSM) elements such as incident management and request fulfillment. The incumbent will also assist with all requests for computer audits, disaster recovery planning and execution of such plans. The incumbent will assist management either directly or through the efforts provided by direct reports, which consist of assigned technical and operational personnel in the Information Technology (IT) group. The incumbent will provide oversight of assigned staff members in the day-to-day operations of the computer infrastructure and operations center units and will monitor and administer reviews for their staff. The incumbent will ensure that all policies and procedures of the organization and IT department are followed and executed in a professional manner. Position Information: 
<ul>
<li>Department: ITS- Infrastructure </li>
<li>Salary Grade: 314 - $99,902 - $159,843 ($48.03 - $76.8476) </li>
<li>Work Arrangement: Full Office **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>50% - Supervisory
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Responds to, updates and completes tickets generated by the Service Desk Ticket system and assigns them to other areas of the IT group accordingly.</li>
<li>Operates an efficient and trouble-free IT infrastructure environment in support of the company's day-to-day business operations.</li>
<li>Assists in recruitment, develops, mentors, supervises and appraises subordinates to provide an efficient and effective operation. Prepares and administers performance evaluations and recommends salary adjustments for staff when appropriate.</li>
<li>Supervises the daily activities of assigned staff to ensure timely and effective reporting, tracking, follow-up and communication of status to management and end-users. Develops and maintains subordinate team's work schedule to achieve optimal coverage and productivity. Performs daily time management and authorization for staff.</li>
<li>Ensures the physical safety of staff in the event of an emergency on premise and at remote sites.</li>
<li>Evaluates and recommends new technologies in desktop, mobility, server, network and storage technology to support business needs.</li>
<li>Collaborates with the team in creating new knowledge articles and updating and migrating existing knowledge articles to the ServiceNow Knowledge Base.</li>
<li>Monitors the Automatic Call Distribution (ACD) queue and ensure timely responses and resolutions within Service Level Agreements (SLAs) </li>
</ul>
</li>
<li>5% - Service Desk Support
<ul>
<li>Ensures that on-boarding tickets have been completed prior to the start date of a new hire, all equipment has been set up and tested and requested folder permissions granted.</li>
<li>Ensures that off-boarding tasks are completed timely, including the retrieval of assets and removal of credentials.</li>
<li>Advises and recommends improvements in organizational, operational, procedural and workflow plans.</li>
<li>Plays a key role in internal Outage processes, assigning tickets and promoting to Problems when necessary and assists in coordinating teams to troubleshoot to resolution.</li>
<li>Participates with on-call support for any production processing and/or infrastructure issues supported by the IT group.</li>
<li>Assists in managing the operation of a data center and its related infrastructure components, including coordinating the monitoring activities for data center server, storage and network communications.</li>
<li>Monitors communications on incident status to end-users and management and participates in more complex IT problem solving and advanced project work.</li>
<li>Aids in asset management and e-waste of IT infrastructure hardware.</li>
<li>Monitors and assigns tickets ensuring they are promptly distributed to the appropriate team members based on priority, complexity and skill set.</li>
<li>Provide and communicate daily and weekly ServiceNow metrics.</li>
<li>Assists with monthly server patching using Tanium. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in business administration, computer science or related field PLUS 3 years of senior level desktop, server, storage, network or telephony communications support experience 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 experience in Microsoft Office 365, Windows PC systems, Active Directory, and/or Microsoft SharePoint Online required. </li>
<li>Experience deploying, troubleshooting and managing Windows 10/11 and macOS/iOS devices in a corporate environment required. </li>
</ul>
 Preferred Qualifications: 
<ul>
<li>ITSM/ Information Technology Infrastructure Library (ITIL) certifications related to the provisioning of services. </li>
<li>CompTIA Security+, CompTIA A+ or HDI Support Center Analyst (SCA) certification. </li>
<li>Microsoft Windows certification. </li>
<li>Apple Certified Support Professional (ACSP), Microsoft Office Specialist (MOS) or equivalent experience. </li>
<li>2 years of supervisory experience or entry level leadership role, scheduling, delegating tasks and assigning resources. </li>
<li>Experience using IT service management solutions. </li>
<li>Government and/or health care experience with general understanding of Protected Health Information (PHI) and Personally Identifiable Information (PII).</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6296758&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 25, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6296758" target="_blank">https://jobs.caloptima.org/jobs/supervisor-information-technology-services-infrastructure-505-city-parkway-west-california-united-states</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-acefa7cc4dc431458ce3f79fb4eba29e

Supervisor Information Technology Services (Infrastructure)

Program/Policy Analyst Sr (Medi-Cal Compliance) CalOptima CalOptima Health is seeking a highly motivated Program/Policy Analyst Sr (Medi-Cal Compliance) to join our team. The Program/Policy Analyst Sr (Medi-Cal Compliance) will coordinate and maintain CalOptima Health's relationship with regulatory agencies and ensure CalOptima Health and its First Tier, Downstream and Related Entities (FDRs) comply with all appropriate standards, regulations, contractual provisions, federal waivers and laws. Specifically, the incumbent works to enhance and strengthen CalOptima Health's policy infrastructure, platform and strategies at the state level, including contract compliance, statutory and regulatory obligations with the Department of Health Care Services (DHCS). The incumbent requires the ability to complete a variety of independent detailed analyses, including the development, review and response to corrective action plans. The incumbent will be responsible implementing Corrective Action Plans (CAPs), supporting regulatory audits, validating regulatory guidance and developing regulatory communications for CalOptima Health stakeholders. The incumbent will interact with CalOptima Health's executives and department management, FDR's management, legal counsel and state and federal regulatory agencies. The incumbent will also support other key CalOptima Health staff on related projects. Position Information: 
<ul>
<li>Department: OOC - MediCal Regulatory Affairs &amp; Compliance </li>
<li>Salary Grade: 311 - $77,863 - $124,581 ($37.43 - $59.8947) </li>
<li>Work Arrangement: Full Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>85% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Works with all of CalOptima Health's departments in response to inquiries, problem-solving and promoting CalOptima Health's mission and message.</li>
<li>Assists in the management of CalOptima Health's daily relationship with the DHCS for CalOptima Health's Medi-Cal program.</li>
<li>Maintains open lines of communication to ensure the ongoing trust and confidence of regulators in the program and management.</li>
<li>Researches, analyzes and makes recommendations regarding the policy implications of major initiatives for CalOptima Health's Medi-Cal program, e.g., integration of new benefits and populations.</li>
<li>Works with business areas at all levels of leadership to validate regulatory communications from regulators impacting CalOptima Health's Medi-Cal program.</li>
<li>Supports process improvements for the Office of Compliance department.</li>
<li>Serves as a Medi-Cal regulatory subject matter expert and lead for CalOptima Health's compliance issues and investigations.</li>
<li>Supports management in the readiness, coordination, oversight and remediation of regulatory audits, including but not limited to validating business area submissions, additional audit requests and written daily reports.</li>
<li>Researches and responds in a professional manner to questions pertaining to the Medi-Cal program.</li>
<li>Works with the director and manager with interactions and responses to regulatory representatives on compliance-related issues as needed.</li>
<li>Reviews and retains working knowledge of Medi-Cal policies and procedures related to assigned programs and projects.</li>
<li>Assists in the creation of communications and strategic alliances with regulators.</li>
<li>Researches and keeps current on the local, state and federal health care environment and health policy, identifying issues that may impact CalOptima Health's Medi-Cal program.</li>
<li>Coordinates the maintenance of public program benefit updates for accurate and consistent application by CalOptima Health and its provider community.</li>
<li>Participates and represents CalOptima Health in meetings and calls with regulators and associations and summarizes key points and impact to CalOptima Health's Medi-Cal program as needed. </li>
<li>10% - Administrative Support</li>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Initiates, facilitates and promotes activities to foster compliance awareness and encourages the reporting of compliance issues within the organization and related entities. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned.</li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in health services administration, public health, public policy or a related field PLUS 4 years of experience in government, public or government affairs role in health care compliance or health plan requirements 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>
</ul>
 Preferred Qualifications: 
<ul>
<li>Master's degree. </li>
<li>Experience working with regulatory agencies in California. </li>
<li>Experience with Medi-Cal regulatory requirements and/or compliance in the areas of Customer Service, Grievance &amp; Appeals, Quality Improvement, Case Management, Claims Administration and/or Utilization Management. </li>
<li>Certification in Healthcare Compliance (CHC) or other compliance related certifications such as Certified Compliance and Ethics Professional.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>n/a</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6296744&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 25, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6296744" target="_blank">https://jobs.caloptima.org/jobs/program-policy-analyst-sr-medi-cal-compliance-505-city-parkway-west-california-united-states</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-c10c0223e159b943b7243c210753f920

Program/Policy Analyst Sr (Medi-Cal Compliance)

Buyer, Sr. CalOptima CalOptima Health is seeking a highly motivated Buyer Sr to join our team. The Buyer Sr will handle complex purchasing assignments such as formal bidding that involves technical specifications and complex evaluation processes. The incumbent will conduct vendor negotiations to obtain the best pricing and a high level of service quality for the organization, conduct contract administration activities to ensure compliance with contact law and CalOptima Health policies, provide subject matter expertise and guidance to team members. Position Information: 
<ul>
<li>Department: Procurement &amp; Vendor Management </li>
<li>Salary Grade: 311 - $77,863 - $124,581 ($37.43 - $59.8947) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>85% - Program Support
<ul>
<li>Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Conducts formal and informal bid process by using tools such as Request for Proposal (RFP), Request for Quotation (RFQ), Request for Qualifications (RFQu) and Invitation for Bid (IFB).</li>
<li>Conducts post bid debriefing with unsuccessful bidders.</li>
<li>Negotiates contract pricing, terms and conditions with successful bidders.</li>
<li>Conducts bi-weekly contract review meetings with business owners.</li>
<li>Reviews invoices and vendor progress reports.</li>
<li>Coordinates vendor management activities and meetings in conjunction with business owner.</li>
<li>Prepares contract amendments, contract terminations and close-out activities.</li>
<li>Ensures timely renewals of contracts and amendments.</li>
<li>Assists business owners in determining appropriate contract types.</li>
<li>Reviews and processes purchase orders.</li>
<li>Enforces internal purchasing, contract administration, and travel policies and procedures.</li>
<li>Researches, interviews, and identifies best-in-class vendors.</li>
<li>Contacts vendors to perform follow-up on orders and expedite or delay orders as needed.</li>
<li>Provides training and support for internal users on purchasing systems.</li>
<li>Serves as a subject matter expert and provides guidance to other team members. </li>
</ul>
</li>
<li>10% - Administrative Support
<ul>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Assists departments in development of purchasing specifications or scopes of work.</li>
<li>Develops and distributes department reports. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Minimum Qualifications: 
<ul>
<li>High School diploma or equivalent PLUS 5 years of purchasing related experience 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>
</ul>
 Preferred Qualifications: 
<ul>
<li>Bachelor's degree in business administration or related field. </li>
<li>Professional certification from a national association (e.g., Institute for Supply Management (ISM) or National Institute of Governmental Purchasing (NIGP)). </li>
<li>Experience with Novatus, Ariett, BidSync or GP Dynamics. </li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6294589&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 25, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6294589" target="_blank">https://jobs.caloptima.org/jobs/buyer-sr-505-city-parkway-west-california-united-states</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-d0b0bd873a15ab43ac36a6d43607460d

Buyer, Sr.

Director, Sales and Marketing (Director I) CalOptima CalOptima Health is seeking a highly motivvresponsible for overseeing the execution and leading the implementation of member outreach, acquisition and retention strategies and tactics. The incumbent will develop and maintain strong relationships between CalOptima Health, current and potential members, employed sales and marketing team, PACE marketing and enrollment team, external Field Marketing Organizations (FMO) or external broker agencies including their independent brokers and contracted health networks and providers throughout CalOptima Health's service area. The incumbent will function as the business over for operations and systems implementation related to sales channels, including broker portals and interfaces. The incumbent will be responsible for increasing the visibility of CalOptima Health's competitive lines of business through marketing, outreach and education. The incumbent will be responsible for driving membership growth through employed and independent agents to increase enrollment into CalOptima Health's competitive lines of business. Position Information: 
<ul>
<li>Department: OneCare Sales &amp; Marketing </li>
<li>Salary Grade: 320 - $170,772 - $273,234 ($82.10 - $131.3625) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<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 marketing and sales department.</li>
<li>Provides direction and accountability, in a dotted line capacity, to the Manager, PACE Outreach and Education and the Senior Director of Strategic Development overseeing Covered California.</li>
<li>Hires and trains department managers and staff, sets monthly or quarterly goals based on direction from the executive director and leadership.</li>
<li>Directs and oversee the participation of the OneCare, PACE and Covered California sales agents at outreach and retention events and activities conducted by the respective outreach and education program managers and staff.</li>
<li>Onboards and manages relationships and production of new enrollment by FMO and/or broker agencies.</li>
<li>Collaborates with executive director, senior director, strategic development and other lines of business leadership and staff in all relevant internal departments to share information and promote a positive and collaborative business relationships with vendors and providers.</li>
<li>Partners with the Provider Relations department to develop and conduct provider communications and updates.</li>
<li>Partners with Health Network Provider Relations department on outreach and updates the contracted networks regarding enrollment strategies and tactics.</li>
<li>Provides subject matter expertise and strategic advice regarding the development of competitive benefit plans for all CalOptima Health competitive lines of business. </li>
</ul>
</li>
<li>50% - Program Oversight
<ul>
<li>Sets monthly and/or quarterly goals from each FMO or broker agency aligned with direction from the executive director, senior director, strategic development and CalOptima Health leadership.</li>
<li>Plans and hosts weekly, monthly and/or quarterly joint operation meetings with each contracted FMO and/or broker agencies.</li>
<li>Oversees the development and content for annual training, certification or re-certification of employed and independent agents.</li>
<li>Develops and oversees an agent/broker customer service support function.</li>
<li>Manages the updates of content for CalOptima Health's Agency and Agent Manuals.</li>
<li>Directs and collaborates closely with internal departments to maintain CalOptima Health's sales agent portal, including maximizing automation of broker support systems and services.</li>
<li>Collaborates with the Communications department and competitive line of business leaders in the development of marketing and advertising campaigns.</li>
<li>Monitors OneCare, PACE and Covered California programs member/participant retention rates, identifies root causes of voluntary disenrollment trends and develops strategies and tactics for maximizing retention and positive member/participant experience and satisfaction.</li>
<li>Ensures compliance with all Center for Medicare &amp; Medicaid Services (CMS), state Medi-Cal and Department of Managed Health Care (DMHC) marketing, sales and enrollment regulations.</li>
<li>Develops and manages the annual departmental budget.</li>
<li>Develop policies, procedures and standards for all department activities and member enrollment processes.</li>
<li>Oversee the maintenance of all department records and reports. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree PLUS 7 years of experience in management position working with the needs of seniors and persons with disabilities in marketing, sales, outreach or enrollment 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>4 years of progressive leadership experience, including direct supervision of staff required. </li>
<li>Health maintenance organization (HMO), Medi-Cal/Medicaid, Medicare and individual market insurance products or Covered California experience required. </li>
<li>Driver's license and vehicle or other approved means of transportation and an acceptable driving record will be required for work away from the primary office 50% of the time or more. </li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Master's degree.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>n/a</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6281715&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 20, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6281715" target="_blank">https://jobs.caloptima.org/jobs/director-sales-and-marketing-director-i-505-city-parkway-west-california-united-states</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-44d9784a7be71b4ea5b8439a9db16b3b

Director, Sales and Marketing (Director I)

Director, Medicare Program Development (Director III) CalOptima CalOptima Health is seeking a highly motivated Director, Medicare Program Development (Director III) to join our team. The Director III (Medicare Program Development) will be responsible for leadership, plan management and operations of CalOptima Health's Medicare lines of business, including the Program of All Inclusive Care for the Elderly (PACE) health plan operations. The incumbent will provide direction to CalOptima Health's departments to ensure compliance with regulatory agencies such as the Centers for Medicare and Medicaid (CMS), Department of Health Care Services (DHCS) and Department of Managed Health Care (DMHC). The incumbent will collaborate with the Operations Management, Clinical Operations, Regulatory Relations and Finance departments, including but not limited to Customer Service, Grievance and Appeals, Medical Management, Provider Network Operations, Strategic Development, Compliance and Regulatory Affairs and subcontracted providers and health networks. The Director III will interact with all levels of CalOptima Health's staff, members, providers, regulatory agencies, advisory committees and representatives of other agencies as needed. Position Information: 
<ul>
<li>Department: Operations Management </li>
<li>Salary Grade: 322 - $192,386 - $307,817 ($92.49 - $147.9891) </li>
<li>Work Arrangement: Partial Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>50% - 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>Hires, supervises, develops, counsels and reviews the performance of department staff.</li>
<li>Supports the development of reports and presentations to CalOptima Health's Board of Directors, as needed.</li>
<li>Utilizes matrix management, directs and coordinates staff throughout the organization in the implementation of strategic work plans, development and implementation of new benefits or other initiatives for health plan operations, including but not limited to CMS Five Star Program operational initiatives and improvement activities.</li>
<li>Ensures implementation of Medicare and PACE program changes to comply with CMS regulatory requirements and is responsible for communication with stakeholders to implement such changes.</li>
<li>Ensures timely filing and compliance with CMS reports and data submissions.</li>
<li>Reviews and recommends approval of OneCare program and PACE health plan operations policies and procedures by the Executive Director and executive leadership. </li>
</ul>
</li>
<li>45% - Program Oversight
<ul>
<li>Directs and leads all business operations associated with the Medicare lines of business operations and supports certain PACE health plan operations, including coordination with and oversight of delegated health networks, contracted providers and contracted vendors.</li>
<li>Directly leads Medicare Programs outreach and retention function including developing strategies designed to expand community outreach and retention of current OneCare members.</li>
<li>Reviews and monitors Medicare programs and PACE program financial performance, provides recommendations and develops action plans.</li>
<li>Develops and monitors strategies and tactics for business development, new member enrollment and member retention in Medicare and PACE programs.</li>
<li>Supports Medicare annual bid submissions, including project management, supplemental benefit development and coordination with external actuary firm(s) and internal departments to complete and submit bids on time for Medicare and PACE programs.</li>
<li>Oversees the development of strategic plans, work plans and other initiatives for the OneCare and PACE program health plan operations.</li>
<li>Collaborates with Finance and other departments to improve activities for Medicare Risk Adjustment Factor (RAF) improvement activities for applicable programs.</li>
<li>Collaborates with internal departments in the implementation and oversight of community and member outreach activities designed to maximize visibility of Medicare programs including OneCare and PACE.</li>
<li>Partners with staff from across the organization to research specific issues as necessary to develop and analyze solutions and make policy or programmatic recommendations to address operational issues.</li>
<li>Reviews reports for submission to CMS, CalOptima Health's Board of Directors, executive leadership and others, as needed.</li>
<li>Facilitates monthly operations meetings to review Medicare and PACE program medical, financial and administrative operations.</li>
<li>Communicates the plan's operational issues, ensures adherence to work plans, identifies problem areas and develops solutions to issues or problems.</li>
<li>Collaborates with Medicare Programs Sales and Marketing and Communications departments in the development of marketing and enrollment strategies and tactics for increasing Medicare and PACE program enrollment and retention. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in business administration or related field PLUS 7 years of experience in a management position of a health insurance plan, Independent Physician Association (IPA), managed care organization or public agency serving Medicare and Medicaid (Medi-Cal) populations 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>7 years of progressive leadership experience, including direct supervision of staff required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Master's degree. </li>
<li>Medicare Advantage health plan operations, Medicare Advantage health maintenance organization (HMO) special needs plans (SNP), Medicaid or Medi-Cal and PACE program operations experience. </li>
<li>Project management experience.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>N/A</li>
</ul>
 Knowledge &amp; Abilities: 
<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>
 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>
 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>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6281703&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 20, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. 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/6281703" target="_blank">https://jobs.caloptima.org/jobs/director-medicare-program-development-director-iii-505-city-parkway-west-california-united-states</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-7afb9ea777e68d4fab491cabeb4bb238

Director, Medicare Program Development (Director III)

I. I. General Summary Responsible for overall control of safety and health for all plant aspects including, but not limited to, OSHA and state related safety compliance, team member health and wellness, and workers' compensation. Coordinates the planning, organizing, scheduling and implementation of safety policies, programs, and procedures within plant including a safety audit/inspection system. Monitors site condition, practices, and procedures for compliance with health and safety requirements. Selects and implements corrective action and follow-up to ensure proper action has been taken. II. Essential Job Functions: A. Assist management in appropriate loss control and accident prevention measures to comply with TBA and plant mission and objectives. B. Ensure plant compliance with current OSHA and other federal, state, and local agency laws and regulations as they pertain to safety and environmental issues. 1. Act as plant liaison with governmental agencies and serves as the plant representative in case of injuries, inspections, etc. to correct deficiencies and minimize impact on the plant. 2. Act as plant liaison with insurance carriers, third party administrators, parent companies, and professional safety and health providers for audits, training, hygiene sampling, etc. 3. Attend necessary seminars and training to maintain and update skills in industrial safety and federal and state occupational safety and health laws and regulations. C. Develop, implement, and manage safety policies, programs, and procedures that will reduce frequency and severity of personal injuries and illnesses. 1. Develop and implement safety policies and procedures based on program needs, laws and regulations, and TBA/TBJ standards. 2. Assist Group Leaders with the evaluation of safety problems and team members' safety recommendations and complaints. Recommend corrective measures accordingly. 3. Perform periodic safety and compliance audits including identifying and promptly informing management of compliance issues, safety risks, and improvement opportunities. 4. Perform accident investigations and implements countermeasures to prevent reoccurrence. Investigate incidents and unsafe working conditions, compiling statistical data and providing remedial actions to achieve effective accident and loss prevention. 5. Conduct risk assessments related to new equipment introductions and jobs performed (Job Hazard Analysis) including ergonomic evaluations and essential job function investigations to identify and recommend appropriate risk mitigation measures and standards for injury/illness prevention. 6. Coordinate all aspects of industrial hygiene programs by establishing baselines and developing systems that reduce workplace exposures. 7. Administer lockout/tagout, electrical safety, overhead crane safety, hearing protection, respiratory protection, hazard communication, hazardous waste operations (HAZWOPER), blood borne pathogens, emergency response, etc. programs. 8. Influence behavior and inspire commitment on the part of all team members in complying with safety standards and maintaining a safe work environment. D. Serve as plant safety and health coordinator. 1. Serve as principle source of information on safety and health of team members. 2. Coordinate Safety Committee and risk assessment activities. 3. Serve as Workers' Compensation administrator, process claims, and conduct related activities. 4. Maintain protocols with workers' compensation carrier regarding team member appointments, diagnosis, litigation, and injury investigation. 5. Correspond with workers' compensation attorney regarding litigations. 6. Coordinate post accident / injury care of team members. 7. Maintain required paperwork, records, and documentation related to accidents, injuries, and illnesses to comply with OSHA, state, and TBA standards. 8. Maintain safety and first aid supplies. 9. Develop and implement behavior based safety programs and recognition and incentives. 10. Maintains up-to-date information and regulatory postings on bulletin boards throughout the plant. E. Develop and deliver training and coaching for team members, contractors, and others on safety, security, and environmental issues to ensure skills competence, understanding of policies and procedures, and to maintain compliance with corporate, federal, state, and local regulations, directives, standards, policies, and procedures. 1. Develop and deliver safety, health, and environmental orientation to new hires, contractors, and others as required. 2. Conduct annual compliance training. 3. Conduct CPR/AED, first aid, and blood borne pathogen training as required. 4. Create and maintain the Safety Dojo. F. Lead and perform security and disaster protection activities. 1. Create appropriate safety standards, conduct tests/audits of system, coordinate fire/tornado drills, communicate risks/problem areas to management, and implement countermeasures. 2. Administer the fire protection program and system engineering to ensure compliance with fire safety and life safety regulations of local, state and federal jurisdictions. 3. Act as primary technical liaison with companies installing, testing, maintaining, and servicing fire alarm, fire extinguishing, and firefighting systems and equipment. 4. Perform in various roles on emergency response teams including first responder, technician, safety officer, and incident commander. G. Administer the construction safety and security programs for modifications and expansion projects and processes through coordination with TBA Production Engineering and their suppliers and contractors. Includes conducting equipment safety reviews in buy-off procedure. H. Conduct periodic inspections of plant machinery, equipment, and working conditions to ensure conformance to appropriate safety and health standards and regulations. I. Maintain accurate daily, weekly and monthly safety and health metrics reporting to onsite management teams and corporate based reporting systems. J. Lead and manage all ISO14001 and related environmental activities. III. Minimum Qualifications/Requirements: Education: • Bachelor's Degree in Safety, Environmental Science, Industrial Hygiene, Engineering or related field required, or an equivalent combination of education and experience. • Certification as Occupational Safety and Health Technician (OSHTEC), Associate Safety Professional (ASP), Certified Safety Professional (CSP), or Certified Industrial Hygienist (CIH). Experience: • Minimum of 4 years diversified experience in safety, loss prevention, emergency response management, consulting, supervision, and administration in a manufacturing environment required (preferably automotive). • Experienced in emergency response and be able to maintain current First Aid and CPR certificates. • Previous exposure to a multicultural office environment preferred. • Toyota Tier 1 or other OEM Tier 1 automotive parts production experience is a plus. Personal/Technical Skills: • Must have a basic knowledge of regulatory requirements including federal and state safety and health laws (e.g., OSHA, EPA, DOT, EPA Risk Management Plans, and Industrial Hygiene). • Must have an understanding of ergonomic principles and company safety procedures, regulations and requirements. • Basic math skills. • Strong leadership qualities. • Excellent problem solving skills. • Effective time management skills. • Strong customer service orientation. • Strong organization and planning skills. • Ability to adopt a self-directed work style. • Hands-on, self-starter with a strong work ethic. • Ability to compile effective and concise visual reports. • Ability to train and transfer knowledge to plant personnel. • Must have demonstrated ability to prioritize and multi-task. • Good collaboration, interpersonal, and communication skills. • Ability to work in a fast-paced, multicultural team environment. • Develop team member relations centered on trust and teamwork. • Ability to work with multiple departments and prioritize activities. • Ability to maintain on call flexibility to control abnormal conditions. • Excellent project skills and ability to coordinate multiple projects and programs. • Ability to maintain confidentiality in matters involving security and/or personnel issues. • Must be able to work a fixed or rotating shift schedule, including daily or weekend overtime. • Ability to clearly communicate and work well with TBA corporate and plant team members at all levels. • Demonstrate a personality that works in cooperation with other departments towards building a sense of company teamwork. • Thorough understanding and working knowledge of TBA's organization, automotive plants and processes/principles, company products, trade terminology, and manufacturing processes, tooling and equipment, and machine operation is a plus. Language Skills: • Strong verbal and written communication skills in English. • Japanese, Spanish, and/or Portuguese would be helpful. Computer/Software: • Solid working knowledge and experience with Microsoft Office and other computer-based applications (e.g., MS Word, MS Excel, MS PowerPoint, Outlook, Internet, etc.). IV. Work Environment/Conditions: Office: Open Office Environment, moderate noise level. Plant: Standard automotive plant environment with moderate noise level. PPE (Personal Protective Equipment) such as safety glasses, steel toe shoes, hearing protection, etc. may be required in engineering, manufacturing, or industrial areas. Personal attire standards may apply. Travel: Must be able to travel 0-40% of the time. V. Physical Demands: Ability to sit and work on a computer for extensive periods of time is required. While performing the duties of this job, the team member is required to talk, see, and hear. The team member must be capable of walking, sitting, and standing for extended periods of time (e.g., during safety audits) and may be occasionally required to lift up to 30 pounds. The ability to travel by automobile and airplane are both required. Disclaimer: This job description is intended to identify the general nature and level of work performed by team members within this classification, as well as certain essential job functions. It is not intended, and should not be interpreted, as a comprehensive inventory of all duties, responsibilities, and qualifications required of team members assigned to this job. To qualify for this job, however, a team member must be able to perform its essential functions with or without reasonable accommodation. Under no circumstances may this job description be construed as altering the at-will nature of the employment relationship between TBA and any team member. EOE Toyota Boshoku America is an equal opportunity employer and considers applications for all positions without regard to race, sex, religion, color, national origin, pregnancy, genetic information or any other characteristic protected by applicable law. If you require a reasonable accommodation to apply for a posted position, please email us at .

EHS Specialist

Southern Oregon University seeks a Provost and Vice President for Academic &amp; Student Affairs Click here to view position profile: <a href="https://summitsearchsolutions.com/wp-content/uploads/2023/07/SOU_Provost_VPAA_SA_Profile.pdf" target="_blank">https://summitsearchsolutions.com/wp-content/uploads/2023/07/SOU_Provost_VPAA_SA_Profile.pdf</a> Location: Ashland, Oregon
The Position: The Provost and Vice President for Academic and Student Affairs (Provost &amp; VPAA/SA) provides vital, creative, and adaptable leadership to the academic enterprise at Southern Oregon University (SOU). This position plays a key role in institutional planning and strategy, in forging community partnerships, and in advancing SOU’s presence in the region, state, and nation. The Provost &amp; VPAA/SA has a significant duty in representing SOU to the Southern Oregon University Board of Trustees, engaging with the Oregon Provosts Council, and participating in the Oregon Council of Presidents. This person is responsible for articulating a vision and direction for Academic and Student Affairs and effectively communicating that vision to the campus community. The Provost &amp; VPAA/SA reports directly to the president and collaborates with the other vice presidents to execute the president's leadership agenda. This position is also responsible for managing the operations of the university in the president’s absence.
The Provost &amp; VPAA/SA oversees all of the academic schools at SOU and the services that support them, as well as the university’s portfolio of student support and success services. This leader is responsible for guiding academic and enrollment planning and shaping the student body through an institutional strategy for recruitment, admission, retention, advising and educational partnerships. Effective performance requires an in-depth understanding of the university’s mission and its various programs, and a commitment to work effectively within a shared decision-making environment (i.e., Faculty Senate, Staff Assembly, and the faculty union). A high level of collaboration, commitment to service excellence, and exceptional listening and communication skills are critical.
Responsibilities:
<ul>
<li>Lead Academic Affairs, establish and communicate a strong academic vision while promoting a culture of shared governance (40%) The Provost &amp; VPAA/SA is the Chief Academic Officer of SOU and provides leadership and robust support for the faculty, academic schools, and the library at SOU. Duties include, but are not limited to: support and promote teaching, scholarship, and community engagement activities; administer contracts; supervise and evaluate the academic directors and faculty personnel roster; launch faculty development programs; assess recruitment and hiring priorities; oversee the promotion and tenure process, faculty appointments, merit salary increases, and sabbatical leaves; respond to faculty grievances; support program review and assessment of the learning enterprise; guide various programs including instructional services, off-campus and continuing education programs, summer session, inter-institutional programs, various galleries and collections, and all that is necessary to support coursework, research, and intellectual exploration associated with the university’s intellectual life; give direction to research, grants and sponsored programs, and other creative endeavors; maintain effective channels of communication with the President, faculty, and Faculty Senate; serve as strategist in the faculty collective bargaining enterprise; and create a culture of collective ownership and accountability while collaborating on decision-making processes quickly and effectively.</li>
<li>Lead Strategic Enrollment Management and Student Affairs (25%) The Provost &amp; VPAA/SA is the Chief Enrollment Officer responsible for the executive leadership, strategic planning, and administrative oversight for all operations and support functions associated with the recruitment, retention, and engagement of students. Duties include, but are not limited to: foster creative thinking that builds on SOU’s strong tradition as a student-centered institution; guide strategic efforts to address issues related to student development, health and wellness, success, equity, and retention; address issues related to the review, implementation, improvement, and enhancement of policies, procedures, and program-specific services; and oversee Enrollment Services, Student Success, and Admissions and Recruitment to ensure efficiency in operations that drive enrollment growth that aligns with institutional goals.</li>
<li>External Outreach (10%) The Provost &amp; VPAA/SA partners with the president to implement SOU’s mission, vision, core values, and strategic directions in a manner that realizes growth that enhances student learning opportunities and positively impacts financial and economic development. This position develops and cultivates public-private partnerships with local, regional, and statewide business and industry.</li>
<li>Accreditation (10%) The Provost &amp; VPAA/SA administers activities related to the accreditation and the external review of SOU and its schools, departments, and programs. This position ensures compliance with various academic disciplines and their respective accreditation agencies.</li>
<li>Budget &amp; Resources (10%) The Provost &amp; VPAA/SA designs effective budget models for Academic and Student Affairs. This position analyzes financial information to include revenues and expenditures to ensure all operations are within budget; develops long-range planning and budget priorities; and provides supervision, evaluation and professional development for administrative and support staff.</li>
<li>Other Duties as Assigned (5%) The Provost &amp; VPAA/SA performs other duties as assigned by the president, including but not limited to: participating or leading ad hoc and standing working and advisory committees; serving on search committees; and representing SOU at functions, panels, and events.</li>
</ul>
Qualifications: Minimum:
<ul>
<li>Ph.D. or other terminal degree with a record of teaching and scholarship suitable for a tenured faculty appointment.</li>
<li>At least five years of successful leadership in a senior level position with academic administration, program development, budgeting, and personnel management experience.</li>
<li>Strong interpersonal, supervisory, and communication skills.</li>
<li>Proven record of a commitment to equity, diversity and inclusion initiatives, and experience with institutional EDI goals and efforts.</li>
<li>Demonstrated record of fostering excellence in teaching, scholarship, and creative endeavor.</li>
<li>Experience developing and overseeing academic programs that increase student access and enrollment.</li>
<li>Thorough understanding of the compelling mission, challenges, and governance of public higher education.</li>
<li>Experience fostering partnerships between a university and the region it serves.</li>
<li>Ability to analyze and interpret data and communicate this to a broad set of audiences.</li>
<li>Demonstrated ability to lead change. Demonstrated effectiveness working with shared governance structures (e.g., Faculty Senate).</li>
</ul>
Preferred:
<ul>
<li>Experience in student affairs.</li>
<li>A record of success leading strategic enrollment management efforts.</li>
<li>Experience in a teaching-focused institution, as well as institutions that serve first-generation non-traditional students.</li>
<li>Experience cultivating successful philanthropic relationships.</li>
<li>Experience working under collective bargaining agreements.</li>
<li>Experience in a liberal arts environment.</li>
</ul>
About the Institution: Established in 1872, Southern Oregon University (SOU) is becoming the ‘University for the Future’, under the direction of President Dr. Richard J. Bailey, Jr., who inspires the community to strive for greatness – individually and collectively. SOU provides career-focused, comprehensive educational experiences to over 5000 students with multiple degree path options through 46 undergraduate and 10 graduate-level academic programs in a dynamic range of fields while preparing them to live and lead in a multicultural, global society. Along with an emphasis on student success and intellectual growth, SOU is committed to diversity, equity inclusion, and sustainability. Theoretical and experiential learning programs provide quality, innovative experiences for learners. At SOU, students build strong community connections through internships, mentorships, field studies, capstone projects, volunteer opportunities, and civic engagement. To learn more: <a href="https://sou.edu/" target="_blank">https://sou.edu/</a>
Sitting on 175 acres, Southern Oregon University is committed to sustainable practices, environmental stewardship, and research that advances understanding of local, regional, and global environmental issues of which it has been nationally recognized. Recently, SOU was honored with the Best Case Study Award by the Association for the Advancement of Sustainability in Higher Education, was the first university in the nation to certify as a Bee Campus USA, and now boasts LEED Gold campus housing.
SOU’s presence is experienced not only in Ashland but also in Medford, Oregon at the Higher Education Center where students pursue two-year, four-year, and graduate degrees. At both locations, the passions of students combine seamlessly with an outstanding education in a unique location making SOU a wonderful place to work, live, and learn.
<ul>
<li>Sierra Magazine ranked SOU one of the top “Cool Schools” in the US</li>
<li>The Princeton Review named SOU one of the most environmentally responsible colleges in the US and Canada</li>
<li>SOU wasawarded 5 out of 5 stars on the Campus Pride Index in 2023</li>
<li>Outside Magazine named SOU one of the top 20 schools in the US where you can hit the books and the back country</li>
<li>SOU participates in Second Nature’s Climate Commitment</li>
<li>SOU is the nation’s first Bee Campus USA, and a designated Tree Campus by the Arbor Day Foundation</li>
</ul>
To Apply: Confidential review of applications will begin immediately and continue until the position is filled; parties who apply by September 5, 2023 will be given first consideration. Please submit a PDF version of your CV and cover letter outlining your interest and suitability for this position. To apply online, go to <a href="https://theapplicantmanager.com/jobs?pos=su357" target="_blank">https://theapplicantmanager.com/jobs?pos=su357</a>
For more information or to offer recommendations or nominations: Andrea Martinez Senior Consultant <a href="https://summitsearchsolutions.com/" target="_blank">Summit Search Solutions, Inc.</a> Direct: 919-357-8766 <a href="mailto:amartinez@summitsearchsolutions.com" target="_blank">amartinez@summitsearchsolutions.com</a>
Southern Oregon University is an equal employment opportunity employer and is strongly committed to achieving excellence through a diverse workforce. The University actively encourages applications of all qualified individuals.

Provost and Vice President for Academic & Student Affairs

TITLE: Research Associate in Entomology and Insect Ecology/Management
DEPARTMENT: College of Agriculture, Community, and the Sciences
REPORTS TO: Principal Investigator
EFFECTIVE DATE: Position will Remain Open until Filled
EMPLOYMENT STATUS: &nbsp;Full-time&nbsp;
EMPLOYMENT CLASSIFICATION:&nbsp;&nbsp;Exempt &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;
Internal Candidates are Encouraged to Apply
Applicants must be authorized to work for any employer in the United States. At this time, Kentucky State University is unable to sponsor or take over sponsorship of an employment visa

PRINCIPAL PURPOSE OF JOB:&nbsp;The Research Associate will serve as a support person for the Entomology and Insect Ecology and Management Program, and will assist in developing, conducting, and managing field and Laboratory research for this program at Kentucky State University. &nbsp; The successful candidate will also help prepare manuscripts for publishing in journals and presenting relevant information at scientific meetings, in addition to Extension and outreach programming such as the KSU Third Thursday Sustainable Ag Workshops. &nbsp; &nbsp;

SCOPE OF RESPONSIBILITY:The successful candidate in this position will work closely with the principal investigator and be a member of a team conducting investigative field and laboratory research focusing on conservation biological control using native perennial plants to increase biodiversity of insect predators and parasitoids (i.e., natural enemies) to manage pest insects in vegetable and fruit crops. Specifically we are attracting several species of lady beetles, lacewings, big eyed bugs, minute pirate bugs, ground beetles and other predators and parasitoids of sweet corn pests to this and other crops. This position will also evaluate/develop sustainable methods of sweet corn insect pest management by conducting laboratory bioassays of flowering plants, weeds, and synthetic herbivore induced plant protection odors which may attract or repel beneficial insects.

This position involves designing and implementing, and maintaining field, laboratory, and greenhouse experiments. &nbsp;It involves setting up experiments, collecting, entering, and statistical analyses of data, assisting with development of manuscripts for publication, PowerPoints for presenting, plus training and supervising other researchers, graduate students, and undergraduates who are conducting research in the program. &nbsp;Experience operating farm machinery (ie. tractors, planters, cultivators, tine weeders, etc.) is preferred. &nbsp;Experience analyzing data using modern statistical software is essential as is fluency in all Microsoft Office Software. &nbsp;&nbsp;

ESSENTIAL JOB FUNCTIONS:
<ol>
<li>Conduct field experiments to determine attractancy of native perennial plants to predatory lady beetles, lacewings, big eyed bugs, minute pirate bugs, ground beetles and other predators and parasitoids of sweet corn, and other vegetable and fruit crop insect pests.</li>
<li>Design, implement, and maintain laboratory, field, and greenhouse experiments.</li>
<li>Design and implement demonstration plots at grower collaborator farms.</li>
<li>Carry out maintenance and management of experiments including plot preparation, planting, weeding, harvesting, seed purchases and detailed record keeping.</li>
<li>Collect, enter, and analyze data for statistical analyses.</li>
<li>Assist in developing manuscripts for publication.</li>
<li>Train, supervise, and mentor research assistants, graduate, undergraduate, and high school students conducting research in this program. &nbsp;</li>
<li>Cursory greenhouse maintenance and management for rearing native perennial plants.</li>
<li>Facilitate and conduct informational talks and tours at field days, national meetings and other events.</li>
<li>Conduct laboratory research using an olfactometer to quantify plant attractancy to insects &nbsp;</li>
<li>Other related duties as required.</li>
</ol>
OTHER DUTIES:&nbsp;The position will conduct other duties as required.

QUALIFICATIONS:&nbsp;Required: M.S. in Entomology, Environmental Science, Horticulture, Agriculture, Soil Science, Agronomy, or related area. &nbsp;One to three years of relevant experience preferred.
Licensing and Certifications:&nbsp; A valid driver’s license is required. Candidate will need to earn pesticide applicators licensethrough the University of Kentucky/Kentucky State University Cooperative Extension Service.
KNOWLEDGE, SKILLS, and ABILITIES:&nbsp;
<ol>
<li>Proficient use of stereoscopic dissecting and compound microscopes.</li>
<li>Be able to identify insects and plants by sight and by use of appropriate taxonomic keys.</li>
<li>Ability to use a personal computer and a variety of related office and statistical software applications.</li>
<li>Good knowledge and appreciation of program clientele.</li>
<li>Knowledge of research and educational capabilities of USDA and the Land Grant system knowledge base in the area of expertise.</li>
<li>Ability to communicate effectively, orally and in writing.</li>
<li>Research skills.</li>
<li>Ability to establish and maintain effective working relationships.</li>
<li>Ability to work independently.</li>
<li>Ability to work in teams and supervise.</li>
<li>Knowledge of farming practices desirable.</li>
<li>To have a valid driver’s license, have daily transportation, and ability to operate a motor vehicle.</li>
</ol>

PHYSICAL REQUIREMENTS:&nbsp;
<ul>
<li>Work involves operating and carrying field-based research equipment and instrumentation</li>
<li>Ability to carry at least 40 lbs</li>
<li>This job involves some travel to scientific meetings and to cooperator farms.</li>
</ul>
Revised: 05/31/2023

KENTUCKY STATE UNIVERSITY is an Equal Opportunity Employer
The functions, qualifications, knowledge/skills, and physical requirements listed in this job description represent the essential duties of the job, which the incumbent must be able to perform either with or without reasonable accommodation. The Job Functions listed do not necessarily include all activities that the individual may perform. The College of Agriculture, Community, and the Sciences strives for inclusive excellence and is interested in qualified candidates who can contribute to this effort through their research, teaching, and/or Extension programs.

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