field_job_employment_type

field_job_occupational_field_parents_all

field_job_experience

job_organization_name

city

state

Program/Policy Analyst (Provider Data) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Program/Policy Analyst (Provider Data) and help shape the future of healthcare where you'll be an integral part of our Provider Data Operations team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You will be responsible for identifying, consolidating and analyzing provider data integrity reports related to provider directories, terminations and attestations. You will ensure data accuracy, completeness and compliance with both regulatory and internal standards. You will collaborate closely with internal departments and health networks to identify and remediate data discrepancies and gaps. You will work within the Provider Data Operations department and play a key role in conducting research, performing data analysis and preparing documentation and reports to support provider data integrity. You will ensure all provider data aligns with CalOptima Health's policies, procedures and applicable regulatory requirements. You will also have analytical and administrative responsibilities specific to the Provider Data Operations department. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>70% - Program Analysis
<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>Analyzes reports related to provider data to ensure compliance with internal guidelines and external regulations, including but not limited to provider directories, onboarding, attestations, termination processes, health network data for network certification and adequacy and the 274 file.</li>
<li>Collaborates with internal teams and health networks to resolve data quality issues and remediate gaps.</li>
<li>Analyzes provider data for accuracy related to contract setup, directory requirements, Cover California network adequacy, fillings and claim processing.</li>
<li>Conducts data integrity activities to support CalOptima's goal of maintaining a high rate of accuracy.</li>
<li>Reviews and breaks down regulatory requirements to identify data impact for audit process updates and implementation.</li>
<li>Maintains ongoing knowledge of provider data requirements and set up within the organization's provider management systems. </li>
</ul>
</li>
<li>25% - Audit Analysis
<ul>
<li>Maintains ongoing reporting formats for use in data auditing and conducts independent analysis of audit results.</li>
<li>Documents audit findings and prepares detailed reports with recommendations for corrective actions.</li>
<li>Collaborates with health networks, providers and internal departments to obtain audit-related information, presents findings and recommendations as appropriate.</li>
<li>Assists with implementing, monitoring and maintaining a well-documented audit trail.</li>
<li>Analyzes regulatory audit requirements, develops workplans and processes. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree PLUS 2 years of experience working with provider data in a health care or managed 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>Experience working in utilization management, quality management, provider data management or related areas required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Experience with regulatory compliance and provider data management.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 309 - $68,015 - $108,824 ($32.70 - $52.3192). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6753496&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 2, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6753496" target="_blank">https://jobs.caloptima.org/jobs/program-policy-analyst-provider-data-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-edb207748d14b047b7263124e9d8fe2a

Program/Policy Analyst (Provider Data)

Director of Development 
Full Time | Staten Island, NY | Flexible, Primarily In-Office Schedule
About the Organization 
A distinguished nonprofit cultural foundation in Staten Island, New York City, dedicated to preserving and celebrating Italian arts, culture, and heritage. Housed in a beautifully restored early 20th-century landmark property, the organization offers year-round cultural programs, culinary and language classes, concerts, films, exhibitions, and festivals that enrich lives and inspire future generations.
Position Overview 
The Director of Development (DD) will partner with the President to design and execute a comprehensive fundraising strategy that meets annual revenue goals. This position oversees all aspects of donor cultivation, membership growth, and corporate sponsorships, and supports signature fundraising events such as the annual Gala and Italian Festival/Exotic Car Show.
As the primary liaison for member engagement, the DD must be personable, outgoing, and relationship-driven—creating meaningful connections, enhancing stewardship, and fostering a strong sense of belonging among members and donors. Some evening and event-related work required.
Key Responsibilities 
• Develop and manage annual and multi-year fundraising plans. 
• Cultivate, solicit, and steward donors, members, and sponsors. 
• Organize member- and donor-focused cultivation events. 
• Prepare corporate sponsorship proposals and renewals. 
• Oversee membership systems, data management, and retention strategies. 
• Support planning and execution of major fundraising events.
Qualifications 
• Bachelor’s degree or equivalent experience. 
• 3–5 years of nonprofit fundraising experience, preferably in arts/culture. 
• Proven track record of meeting fundraising goals. 
• Excellent communication, relationship-building, and organizational skills. 
• Proficiency with Microsoft Office and donor CRM (Salesforce or Donor Perfect preferred). 
•&nbsp;Affinity for Italian arts and culture strongly preferred.
Compensation &amp; Benefits 
Salary commensurate with experience, starting at $120,000 with bonus potential. Full-time (approx. 35 hrs/week) with flexible, primarily in-office schedule. Benefits buy-in option with more than half of individual coverage costs contributed by employer.
To Apply: 
Submit your résumé and cover letter via the Apply button.
No phone calls please.
Equal Opportunity Employer: 
We are committed to building a diverse and inclusive workplace and welcome applicants from all backgrounds.

Director of Development | Arts & Cultural Foundation – Staten Island

Salesforce / CRM Architect (ITS Architect III) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Salesforce / CRM Architect (ITS Architect III) and help shape the future of healthcare where you'll be an integral part of our IT - Applications Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You, as the ITS Architect III (Salesforce/CRM), is a seasoned technologist and subject matter expert (SME) that will be responsible for architecting and delivering enterprise-grade Customer Relationship Management (CRM) solutions that drive digital transformation at CalOptima Health. You will focus on the strategic design, integration, and optimization of Salesforce and related CRM platforms to enhance member, provider, and staff engagement. Alos, you will lead the development of scalable, secure, and high-performing CRM architecture that aligns with business goals and regulatory requirements. You will collaborate with cross-functional teams to define CRM roadmaps, evaluate vendor solutions, and implement best practices for data integration, automation, and user experience; this includes working closely with internal teams and external partners to ensure seamless integration with other enterprise systems, including data platforms and cloud services. You will guide technical teams, influence stakeholders, and ensure alignment across strategic initiatives. Lastly, you will also support vendor management, solution governance, and continuous improvement efforts within the Information Technology (IT) organization. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>90% - Technical Functions
<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>Leads and designs scalable, secure, and high-performance Salesforce and CRM solutions that align with enterprise architecture standards and business goals.</li>
<li>Serves as a trusted advisor to business and IT stakeholders on CRM capabilities, limitations, and roadmap planning.</li>
<li>Defines and maintains the CRM architectural blueprint, including data models, integration patterns, and system interfaces. </li>
<li>Architects seamless integration between Salesforce and other enterprise systems (e.g., Data warehouses, Member/Provider Portals, Claims Payment Systems).</li>
<li>Defines data governance, synchronization, and migration strategies to ensure data quality and consistency across platforms. </li>
<li>Collaborates with Data Architects to align CRM data models with enterprise data architecture.</li>
<li>Serves as a technical lead to development teams, ensuring adherence to best practices in Apex, Lightning Web Components, and declarative tools.</li>
<li>Works with offshore and local vendor teams, offering Salesforce technical guidance and oversight as required.</li>
<li>Establishes and enforces CRM development standards and code reviews, and releases management processes.</li>
<li>Ensures CRM solutions comply with enterprise security policies, HIPAA, and other regulatory requirements.</li>
<li>Works directly with cross-functional IT teams and business partners on technology solutions to solve business challenges. </li>
<li>Defines and publishes cloud architecture guidelines and documentation to support the commitment to best practices. </li>
</ul>
</li>
</ul>
<ul>
<li>10% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree in information systems, computer science or related technical discipline PLUS 8 years of progressive, applicable, technical experience in information technology required, including cloud architecture; 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>5 years of experience specifically in Salesforce architecture and CRM solution design, with a proven track record of delivering successful end-to-end implementations from inception to deployment required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Salesforce certifications such as: 
<ul>
<li>Salesforce Certified Application Architect </li>
<li>Salesforce Certified System Architect </li>
<li>Salesforce Certified Technical Architect (CTA) - highly desirable </li>
</ul>
</li>
<li>Experience with cloud-native architecture and distributed systems, especially in the context of CRM platforms and customer data management. </li>
<li>Managed care/health care experience. </li>
<li>Strong vendor management experience. </li>
<li>Project management experience. </li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 316 - $120,881 - $193,410 ($58.12 - $92.9856). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**) Position will be Partial Telework for the first 3 months for training purposes. </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6753408&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 8, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6753408" target="_blank">https://jobs.caloptima.org/jobs/salesforce-crm-architect-its-architect-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-c6daf0c631ad8947b3f76f0747bbb037

Salesforce / CRM Architect (ITS Architect III)

Medical Case Manager (High Risk Pregnancy) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Medical Case Manager (High Risk Pregnancy) and help shape the future of healthcare where you'll be an integral part of our Case Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Case Management is an advanced specialty collaborative practice, responsible for providing ongoing case management services for CalOptima Health's members. The Medical Case Manager, High-Risk Pregnancy, will facilitate communication and coordination among all participants of the health care team and the member to ensure that the services provided promote quality, cost-effective outcomes. You will be a resource for high-risk pregnancy members, delegated plan Case Managers, Personal Care Coordinators (PCCs) and community partners to address medical, behavior and psychosocial concerns. In conjunction with other team members, you will develop and make recommendations for a comprehensive individualized care plan at all levels of care. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Case Management
<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>Reviews and analyzes member health risk assessment (HRA) answers and uses clinical judgment to assign a care management level (CML).</li>
<li>Reviews Interdisciplinary Care Team (ICT) summaries and individual care plans (ICP) to ensure compliance with Centers for Medicare and Medicaid Services (CMS) and Model of Care requirements.</li>
<li>Works collaboratively with the PCCs to develop care plans for members, including those who are pregnant, using member HRA data.</li>
<li>Utilizes all other available data to formulate care plans in the absence of an HRA.</li>
<li>Ensures and facilitates communication between PCCs and delegated plan PCCs to achieve favorable member health outcomes.</li>
<li>Responds appropriately to case management triggers generated as part of the HRA or ICT process.</li>
<li>Anticipates needs for those at risk of transitioning of care and proactively support reducing the risk of re-entering a higher level of care.</li>
<li>Acts as an integral part of the team, providing verbal and written support of member needs.</li>
<li>Collaborates and communicates with the member, family, significant other(s), physicians, health network (HN) designee and other health care providers to support and accomplish goals identified on the individualized care plan in all care settings.</li>
<li>Accepts referrals for case management and serves as CalOptima Health's liaison to community agencies, organizations and state personnel.</li>
<li>Provides case management consultation and education to members, their families and the HNs.</li>
<li>Acts as an advocate to assist in the coordination of the client's identified psychosocial needs, utilizing community resources and support when appropriate.</li>
<li>Participates in proactive identification of patients appropriate for care management.</li>
<li>Initiates appropriate follow-up and the development of an individual care plan incorporating assessment, education, resource planning and coordination of services of those patients accepted for case management.</li>
<li>Assists, as requested, to collect and analyze data from initial/annual/updated health risk assessments, stratification tools, outcome measures and internal/external reports to identify trends, individual issues, problems and resources that are most appropriate to meet client's needs.</li>
<li>Develops and maintains a network of current community resources and services where members can be referred for assistance.</li>
<li>Performs regular review of cases and events to identify patterns/trends and to ensure the department's compliance with CMS, Department of Health Care Services (DHCS) and National Committee for Quality Assurance (NCQA) standards.</li>
<li>Maintains documentation of case management plans/interventions and statistics required to demonstrate activities of the ICT and the impact of case management, quality and care settings that best meet the member's needs.</li>
<li>Serves as a liaison and resource between CalOptima Health and the HNs departments, as applicable.</li>
<li>Develops and maintains a good working relationship with all areas. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned.</li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Associate degree in nursing (ADN) or related field PLUS 3 years of clinical experience working with pregnancy and/or managed care 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>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Bachelor of Science degree in Nursing (BSN), public health or a related field. </li>
<li>Active and unrestricted Registered Nurse CCM certificate. </li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese). </li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>Current unrestricted Registered Nurse (RN) license to practice in the state of California required.</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 313 - $90,820 - $145,312 ($43.66 - $69.8615). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**) NOTE: Training will be held in the office for the first 4 weeks from 8:00am - 5:00pm, on Tuesdays and Thursdays. </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6753575&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 8, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6753575" target="_blank">https://jobs.caloptima.org/jobs/medical-case-manager-high-risk-pregnancy-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-2aff510fae8fb6448a86895170bc50fc

Medical Case Manager (High Risk Pregnancy)

Medical Case Manager (LVN) (High Risk Pregnancy) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Medical Case Manager (LVN) (High Risk Pregnancy) and help shape the future of healthcare where you'll be an integral part of our Case Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Case Management is an advanced specialty collaborative practice, responsible for providing ongoing case management services for CalOptima Health's members. The Medical Case Manager (LVN), High-Risk Pregnancy, will facilitate communication and coordination among all participants of the health care team and the member to ensure that the services provided promote quality, cost-effective outcomes. You will be a resource for high-risk pregnancy members, delegated plan Case Managers, Personal Care Coordinators (PCCs) and community partners to address medical, behavior and psychosocial concerns. In conjunction with other team members, you will develop and make recommendations for a comprehensive individualized care plan at all levels of care. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>95% - Case Management
<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>Reviews and analyzes member health risk assessment (HRA) answers and uses clinical judgment to assign a care management level (CML).</li>
<li>Reviews Interdisciplinary Care Team (ICT) summaries and individual care plans (ICP) to ensure compliance with Centers for Medicare and Medicaid Services (CMS) and Model of Care requirements.</li>
<li>Works collaboratively with the PCCs to develop care plans for members, including those who are pregnant, using member HRA data.</li>
<li>Utilizes all other available data to formulate care plans in the absence of an HRA.</li>
<li>Ensures and facilitates communication between PCCs and delegated plan PCCs to achieve favorable member health outcomes.</li>
<li>Responds appropriately to case management triggers generated as part of the HRA or ICT process.</li>
<li>Anticipates needs for those at risk of transitioning of care and proactively support reducing the risk of re-entering a higher level of care.</li>
<li>Acts as an integral part of the team, providing verbal and written support of member needs.</li>
<li>Collaborates and communicates with the member, family, significant other(s), physicians, health network (HN) designee and other health care providers to support and accomplish goals identified on the individualized care plan in all care settings.</li>
<li>Accepts referrals for case management and serves as CalOptima Health's liaison to community agencies, organizations and state personnel.</li>
<li>Provides case management consultation and education to members, their families and the HNs.</li>
<li>Acts as an advocate to assist in the coordination of the client's identified psychosocial needs, utilizing community resources and support when appropriate.</li>
<li>Participates in proactive identification of patients appropriate for care management.</li>
<li>Initiates appropriate follow-up and the development of an individual care plan incorporating assessment, education, resource planning and coordination of services of those patients accepted for case management.</li>
<li>Assists, as requested, to collect and analyze data from initial/annual/updated health risk assessments, stratification tools, outcome measures and internal/external reports to identify trends, individual issues, problems and resources that are most appropriate to meet client's needs.</li>
<li>Develops and maintains a network of current community resources and services where members can be referred for assistance.</li>
<li>Performs regular review of cases and events to identify patterns/trends and to ensure the department's compliance with CMS, Department of Health Care Services (DHCS) and National Committee for Quality Assurance (NCQA) standards.</li>
<li>Maintains documentation of case management plans/interventions and statistics required to demonstrate activities of the ICT and the impact of case management, quality and care settings that best meet the member's needs.</li>
<li>Serves as a liaison and resource between CalOptima Health and the HNs departments, as applicable.</li>
<li>Develops and maintains a good working relationship with all areas. </li>
</ul>
</li>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>High school diploma or equivalent PLUS 1 year of clinical experience working with pregnancy and/or managed care 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>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Associate degree in nursing (ADN), public health or a related field. </li>
<li>Active and unrestricted Registered Nurse CCM certificate. </li>
<li>Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese).</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>Current unrestricted Licensed Vocational Nurse (LVN) license to practice in the state of California required.</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 311 - $77,863 - $124,581 ($37.43 - $59.8947). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**) ***Training will be held in the office for the first 4 weeks from 8:00am - 5:00pm, on Tuesdays and Thursdays. </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6753587&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 8, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6753587" target="_blank">https://jobs.caloptima.org/jobs/medical-case-manager-lvn-high-risk-pregnancy-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-6f46a4a5bd072343aa775a9395f14428

Medical Case Manager (LVN) (High Risk Pregnancy)

Designer, Website and Online Content CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Designer, Website and Online Content and help shape the future of healthcare where you'll be an integral part of our Communications team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. You, The Designer (Website and Online Content) will provide technical and subject matter expert support for website and intranet content management and frontend user interface design and maintenance. You will ensure website content is current and timely, make regular website updates, and design and maintain graphical user interfaces and graphic elements for the website. You will also work with the Information Technology (IT) department and within the Communications department to design and implement new website features. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>65% - Website Content and Design
<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>Coordinates with various departments to identify business needs for website, social media, and other online content, and ensures content meets organization and regulatory requirements.</li>
<li>Makes regular and timely content changes on the website, social media, and other online platforms using content management software.</li>
<li>Supports the accuracy of website content by proofreading and verifying materials during the posting process.</li>
<li>Designs and builds web pages using Hypertext Markup Language (HTML), Cascading Style Sheets (CSS), and content management software.</li>
<li>Oversees the processes for requesting and completing website, social media, and online updates.</li>
<li>Collaborates with IT and within the Communications department to design, develop and implement new website, social media, and other online features and initiatives.</li>
</ul>
</li>
</ul>
<ul>
<li>30% - Website/Document Optimization and Accessibility
<ul>
<li>Creates and optimizes PDF files and other electronic documents and media files for the website and other online platforms. </li>
<li>Collaborates with IT to ensure web pages, PDF, Word, Excel, PowerPoint, and other electronic documents on the website are accessible to people with disabilities and meet Section 508 regulatory requirements. </li>
</ul>
</li>
</ul>
<ul>
<li>5% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree in communications, graphic design or related field PLUS 3 years of professional web design and content management 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>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Experience in testing websites with automated testing tools and assistive technology such as screen readers, screen magnifiers, and speech recognition software. </li>
<li>Strong project management skills. </li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 310 - $72,096 - $115,353 ($34.66 - $55.4582). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6753555&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 8, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6753555" target="_blank">https://jobs.caloptima.org/jobs/designer-website-and-online-content-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-a11baa3173f7d642ac00713cec3fb305

Designer, Website and Online Content

Assistant Vice Chancellor, Donor Engagement University of California Los Angeles Budgeted Pay Scale: Full Salary Range: Special Instructions to Applicants A resume, cover letter and completed application are required to be considered for this position. **Please note, this is a hybrid role.** Position Summary As UCLA's next Assistant Vice Chancellor of Donor Engagement, you will lead the transformation of how the university connects with and inspires its donors. This pivotal role offers the opportunity to shape the future of donor relations by expanding, enhancing, and elevating the ways we build meaningful, lasting partnerships. Serving as a key strategic advisor and collaborator to the Associate Vice Chancellor for Development, you will help define the vision, priorities, and strategies that drive engagement and philanthropic success across the institution. Through direct reports, the AVC oversees the offices of: Donor Relations; Prospect Management and Development Analytics; Budget, Prospect Research; Campaign Operations; Gift Policy; and Development Events. Your leadership will foster a culture of creativity, collaboration, and innovation, including the integration of AI and data-driven tools to advance the art and science of donor engagement. Charged with building trust, managing and maximizing resources, we will look to you to think critically and strategically as you engage directly with our top-level donors to create solutions for complex inquiries and issues that increase donor satisfaction and continued giving. Your analytical and strategic abilities will inform key performance metrics, guiding decisions that elevate both the donor engagement function and the broader development organization. This is a rare opportunity to make a lasting impact at one of the world's preeminent universities-where your vision, leadership, and creativity will shape the future of philanthropy and deepen the culture of generosity that defines UCLA. UCLA is a great place to work, helping you achieve financial well-being with a pension and other retirement savings plans. Explore more and embark on a rewarding career with us today. Salary &amp; Compensation *UCLA provides a full pay range. Actual salary offers consider factors, including budget, prior experience, skills, knowledge, abilities, education, licensure and certifications, and other business considerations. Salary offers at the top of the range are not common. Visit <a href="https://apptrkr.com/get_redirect.php?id=6751988&amp;targetURL=https://ucnet.universityofcalifornia.edu/compensation-and-benefits/index.html" target="_blank">UC Benefit package</a> to discover benefits that start on day one, and <a href="https://apptrkr.com/get_redirect.php?id=6751988&amp;targetURL=https://ucnet.universityofcalifornia.edu/compensation-and-benefits/total-compensation-calculator.html" target="_blank">UC Total Compensation Estimator</a> to calculate the total compensation value with benefits. Qualifications 
<li> Minimum of 15 years of progressive management experience in advancement. (Required) </li>
<li> Experience managing the nuances of donor relations as well as stewardship processes and practices in a large, complex organization. (Required) </li>
<li> Experience overseeing an integrated prospect development unit. (Required) </li>
<li> Expertise using broad range of communication methods to shape and advance management initiatives, while building alliances and partnerships. (Required) </li>
<li> Experience leading effective strategic planning processes. (Required) </li>
<li> Experience leading, coordinating and implementing effective planning, budget and financial management processes in a large, complex organization. (Required) </li>
<li> Experience developing, coordinating and implementing metrics to measure performance of teams, processes, and services. (Required) </li>
<li> Demonstrated experience building an environment focused on client service. (Required) </li>
<li>Expertise in management of large, complex fundraising teams and operations. (Required)</li>
<li>Demonstrated strength in building effective relationships with internal and external partners. (Required)</li>
<li>Expertise in implementing and using AI tools in fundraising initiatives. (Required)</li>
<li>Ability to motivate and lead staff and partners to bring External Affairs vision to life. (Required)</li>
<li>Open and collaborative leadership style. (Required)</li>
<li>Expertise in communicating effectively. (Required)</li>
 Special Conditions for Employment 
<li>Background Check: Continued employment is contingent upon the completion of a satisfactory background investigation.</li>
<li>Ability to work evenings and/or weekends as needed. (Required)</li>
<li> Ability to travel as needed.</li>
 Schedule 8:00 a.m. to 5:00 p.m. Union/Policy Covered 99-Policy Covered To apply, please visit: <a href="https://apptrkr.com/6751988" target="_blank">https://jobs.ucla.edu/careers-home/jobs/9138</a> Application Deadline: 8:50 p.m. on 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-f59bdcb8b1007a4997017951ed7f9e61

Assistant Vice Chancellor, Donor Engagement

Talent Staffing Representative (Human Resources Representative) CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Talent Staffing Representative (Human Resources Representative) and help shape the future of healthcare where you'll be an integral part of our HR - Talent team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Under general supervision, you will work closely with hiring managers to gain exposure to recruiting, evaluating job candidates and advising managers throughout the recruitment process. You will be responsible for full-cycle regular and temporary recruitments, including recruiting, screening, interviewing, advertising and negotiating offers with internal and external applicants. Also, you will be responsible for negotiating offers with contracted staffing agencies and source candidates as needed by the Talent Acquisition team. You will create processes to ensure accuracy of records, conduct analysis of various HR recruitment matters and may recommend solutions to management and employees. You will exercise some control over ongoing work priorities to ensure the best talent is hired, as well as act with discretion and judgment within the HR department and with CalOptima Health employees. You will also oversee the CalOptima Health telework program and assist departments in identifying, selecting and deploying employees to regular telework. In addition, you will provide support for managers and monitor the program for management. Lastly, you may provide training, write reports and essentially be the organization's resident telework expert. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>60% - Talent Acquisition
<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>Interacts and develops relationships with hiring managers to anticipate their recurring staffing needs to fit the needs/demands of the business.</li>
<li>Works closely with hiring managers to schedule and review service level agreements (SLAs) and determine job requirements for hiring before recruitment begins.</li>
<li>Determines applicant requirements by studying the job description and job qualifications.</li>
<li>Evaluates applicants by discussing job requirements and applicant qualifications and ensures applicants are interviewed on a consistent set of qualifications.</li>
<li>Arranges and schedules applicant interviews with management by coordinating schedules and going through next recruitment steps at the completion of the interview.</li>
<li>Provides on-going interview training for hiring managers.</li>
<li>Participates in the preparation of job offer analyses and proposed pay rates, using consistent methodology and fact-based reasoning; presents offers to HR Manager and Director for review and approval.</li>
<li>Begins to develop networks through industry contacts, association memberships, trade groups and employees.</li>
<li>Researches and recommends sources (e.g., professional networking sites, etc.) for active and passive candidate recruitment. Begins to build networks to find qualified passive candidates.</li>
<li>Provides advice and support to management and staff on recruitment and participates in the decision-making processes at each level.</li>
<li>Assists the HR team in identifying and implementing recruitment process improvements.</li>
<li>Monitors and identifies trends associated with key performance indicators (time-to-fill, etc.) and service level targets. </li>
<li>Collaborates with internal and external resources to identify root causes and best practices to develop appropriate action plans.</li>
<li>Works with temporary staffing agency, including, but not limited to, screening, identifying, interviewing, hiring, invoicing and completing other administrative duties associated with the program. </li>
</ul>
</li>
</ul>
<ul>
<li>30% - Telework
<ul>
<li>Oversees all aspects of the telework program, including full, partial, temporary and occasional programs as well as handling all inquiries, processing all deployments, return to work initiations and other day-to-day items.</li>
<li>Ensures all data is updated and accurate in the Human Resources Information System (HRIS).</li>
<li>Maintains all records, performance management tools and continually tracks progress for each teleworker.</li>
<li>Trains managers on how to monitor performance of teleworkers, including measuring performance and providing feedback, establishing performance measures and communicating to an employee their standing on performance.</li>
<li>Coordinates and monitors Telework Safety Reviews to ensure employees meet safety protocols and CalOptima Health guidelines while teleworking.</li>
<li>Coordinates and assists the Environmental Health and Safety department with Home Office Evaluations to ensure employees meet all assessment requirements.</li>
<li>Partners with functional areas within HR and across the agency to change employee worksite arrangements.</li>
<li>Confers with management, supervisors and employees to gain knowledge of work situations requiring training and to better understand changes in policies, procedures, regulations, business initiatives and technologies.</li>
<li>Measures telework satisfaction through focus groups, questionnaires or surveys.</li>
<li>Reviews and evaluates employee telework suitability with managers based on eligibility criteria, department needs and employee's work style.</li>
<li>Conducts discussions with managers about telework and department impact and the effects on full office workers and guides departments in the creation of plans to ensure adequate office supervision.</li>
<li>Recommends enhancements to the overall program through surveys and coordinates plan of action to implement improved changes. </li>
<li>Maintains and updates telework policies and guidelines. </li>
</ul>
</li>
</ul>
<ul>
<li>10% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree in human resources management, business administration, communications or related field PLUS 3 years of HR or related administration experience with 2 of those years in recruiting or staffing 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>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Experience with an applicant tracking system (ATS). </li>
<li>Experience with a vendor management system (VMS). </li>
<li>Program management experience.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>N/A</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 309 - $68,015 - $108,824 ($32.70 - $52.3192). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6751651&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 7, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6751651" target="_blank">https://jobs.caloptima.org/jobs/talent-staffing-representative-human-resources-representative-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-53d3f8acb534f746b79f335ae78c0e07

Talent Staffing Representative (Human Resources Representative)

Sr Director, Pharmacy Management CalOptima Join Us in this Amazing Opportunity The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Sr Director, Pharmacy Management and help shape the future of healthcare where you'll be an integral part of our Pharmacy Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. Under the direction of the CMO, you will be responsible for strategic planning and leadership, regulatory compliance, and management as well as operational oversight for all aspects of pharmacy services within a managed care organization, including Medi-Cal, Medicare Advantage Part D (HMO D-SNP), and Covered California. You will also be responsible for designing, implementing, and evaluating pharmacy benefit programs that align with clinical goals, financial sustainability, regulatory compliance, and member outcomes. You will develop and direct formulary strategy, utilization management, quality initiatives, and vendor performance-including Pharmacy Benefit Manager (PBM) oversight-and serves as the organization's principal pharmacy advisor to executive leadership and the Board of Directors. You will ensure compliance with Centers for Medicare &amp; Medicaid Services (CMS), state Medicaid, Covered California, Department of Managed Health Care (DMHC), and National Committee for Quality Assurance (NCQA) standards while advancing initiatives to improve population health, medication adherence, and cost-effective drug use. You will be accountable for pharmacy-related quality programs and will contribute to the improvement of CalOptima Health's quality performance including but not limited to Star ratings. This position will require a dynamic, data-driven leader with extensive experience in managed care pharmacy, cross-functional collaboration, and a strong understanding of the regulatory environment governing Medicare, Medicaid, and commercial health plans. You will ensure alignment with CalOptima Health's mission to serve member health with excellence and dignity, respecting the value and needs of each person through collaboration with our providers, community partners and local stakeholders. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>60% - Leadership Responsibilities
<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 oversees the Pharmacy department in carrying out all department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals and priorities.</li>
<li>Leads, develops, and implements pharmacy business plan and strategic initiatives in alignment with CalOptima Health's objectives and community mission, while taking ownership of both short- and long-term direction of the department.</li>
<li>Supports CalOptima Health's quality goals by driving improvements in Covered California Quality Transformation Initiative, Star Ratings, Pharmacy Quality Alliance (PQA) adherence measures, Healthcare Effectiveness Data and Information Set (HEDIS) outcomes, and other not yet identified quality programs.</li>
<li>Delivers effective service management through the definition and adoption of a governance practice that uses key performance indicators (KPIs) and metrics to track and measure the quality of service. Continually monitors metrics and the integration of them with key accountabilities to ensure consistency of approach and continual service improvement.</li>
<li>Oversees and ensures pharmacy management operational compliance with organizational standards, policies and procedures, and regulatory requirements while maintaining knowledge of related changes and developing effective communication plans as needed.</li>
<li>Serves as pharmacy subject matter expert to the executive team and CalOptima Health's Board of Directors.</li>
<li>Directs all aspects of running an efficient Pharmacy team, including hiring, supervising, coaching, developing, disciplining, motivating as well as attracting and retaining a high-performing team that achieves department goals that are in alignment with the CalOptima Health Strategic Plan.</li>
<li>Develops, implements, and upholds departmental policies and procedures.</li>
<li>Collaborates with CMO to develop and monitor annual budgets and corresponding business cases to ensure utilization meets strategic, operational, and budgetary goals.</li>
<li>Collaborates with CMO to manage staffing model and succession planning, and monitors related resource allocation for the department.</li>
<li>Collaborates with CMO and other senior leaders to develop projections for future year utilization and cost trends.</li>
<li>Supports senior leadership within CalOptima Health to drive and lead changes by communicating goals clearly and developing relationships with key stakeholders.</li>
<li>Serves in a Pharmacy and Therapeutics (P&amp;T) Committee Leadership role.</li>
<li>Collaborates with leadership and staff across internal departments to share information, support organization goals, and promote positive and collaborative business relationships with vendors and providers. </li>
</ul>
</li>
<li>35% - Program Operations Oversight
<ul>
<li>Leads and manages all pharmacy-related operational and clinical functions, including but not limited to formulary development, prior authorization protocols, and utilization management for Medi-Cal, Medicare, and Covered California lines of business as appropriate.</li>
<li>Directs the Pharmacy team, including clinical pharmacists, pharmacy operations, and analytic staff, fostering a culture of continuous improvement, excellence and innovation, and promotes collaboration between the Pharmacy team and other internal departments and external providers.</li>
<li>Oversees new program development related to pharmacy, including overseeing new program design and implementation for the Covered California line of business.</li>
<li>Collaborates with internal departments (Medical Management, Quality, Compliance, Finance, line-of business leaders, etc.) to optimize member outcomes and drug cost-effectiveness.</li>
<li>Ensures compliance with state and federal regulations, including CMS, DMHC, Covered California, and Medi-Cal Rx.</li>
<li>Leads Pharmacy Benefit Manager (PBM) procurement, contracting, implementation, oversight and vendor management, including contract negotiation, performance evaluation, and rebate management. PBM oversight is a critical requirement of this role including real time oversight of PBM Point of Service prescription fulfillment.</li>
<li>Collaborates with CMO to provide financial oversight, budget planning, and reporting for pharmacy benefit expenditures, ensuring transparency and fiscal responsibility.</li>
<li>Develops and oversees pharmacy-related internal statistical and performance reports and satisfies reporting requirements to external regulators.</li>
<li>Develops, implements, and monitors department's performance standards.</li>
<li>Manages audit preparation and corrective action plans in response to CMS, DHCS, and other regulatory bodies. </li>
</ul>
</li>
<li>5% - Completes other projects and duties as assigned. </li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Doctor of Pharmacy (PharmD) PLUS 7 years of health plan experience in Medicare Part D and Medicaid required. </li>
<li>5 years of pharmacy management experience with implementation of commercial managed care products, such as products sold on state-based exchanges/Covered California required. </li>
<li>3 years of progressive pharmacy leadership experience within a managed care, health plan, or PBM environment required. </li>
<li>Demonstrated success in directing and overseeing pharmacy benefit strategy, regulatory compliance, and PBM/vendor contracts required. </li>
<li>Experience with CMS audits, DHCS guidelines, and California Medicaid programs required.</li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>15 years of health plan and pharmacy experience in Medicare Part D and Medi-Cal. </li>
<li>Pharmacy Residency in Managed Care or Pharmacy Practice.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>A current, valid and unrestricted California State Pharmacy License and PharmD.</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 324 - $216,737 - $346,778 ($104.20 - $166.7201). 
<ul>
<li>The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Office (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6749750&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 7, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6749750" target="_blank">https://jobs.caloptima.org/jobs/sr-director-pharmacy-management-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-b834097b3b6e134b8064c5e23883c40a

Sr Director, Pharmacy Management

Sr. Configuration Analyst (ITS Analyst, Sr.) CalOptima Join Us - Where Your Talent Meets Opportunity. We're Better Together The Team You'll Join We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all. More About the Opportunity We are hoping you will join us as a Sr Configuration Analyst (ITS Analyst Sr) and help shape the future of healthcare where you'll be an integral part of our CM - Clinic Ops Admin team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. The Configuration Analyst Sr will lead the design, development, and implementation of configuration solutions within the JIVA system to support enhancement and configuration requests for clinical applications, operating within an Agile Framework. You will collaborate with Configuration Management Specialist, business stakeholders, Information Technology (IT), and 3rd party vendors hosting the SAS solution in Agile ceremonies to deliver high-quality, compliant, and efficient configuration solutions iteratively. You will ensure configurations meet business needs, system capabilities, and regulatory requirements while contributing to sprint goals. Together, we are building a stronger, more equitable health system. Your Contributions To the Team: 
<ul>
<li>60% - Configuration Implementation and Delivery
<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>Configuration Implementation: Executes configuration tasks within the JIVA system during sprints, creating and modifying assessments, letters, and business rules to align with business needs and system standards.</li>
<li>Vendor Collaboration: Engages in ticket review meetings to escalate issues, discuss complex tickets, and ensure timely resolution of challenges.</li>
<li>Cross-Team Collaboration: Works closely with IT, shared services, and Configuration Management Specialists in Agile ceremonies to address complex requests, resolve dependencies, and ensure seamless integration of configurations with other systems.</li>
<li>Testing and Validation: Conducts unit testing during sprints and support user acceptance testing (UAT) in sprint reviews to validate configurations meet acceptance criteria and business requirements.</li>
<li>Documentation: Maintains detailed documentation of configuration changes, technical specifications, and processes in Agile tools (e.g., Jira) to ensure traceability, compliance, and knowledge sharing.</li>
<li>Issue Resolution: Troubleshoots and resolves configuration-related issues within sprints, escalating to the JIVA vendor or IT teams when necessary to maintain system stability and sprint commitments.</li>
<li>Compliance and Standards: Ensures all configurations adhere to organizational standards, regulatory requirements (e.g., HIPAA), and JIVA system best practices throughout the Agile delivery process.</li>
<li>Knowledge Sharing: Serves as a subject matter expert and shares expertise with team members through mentoring, training, or documentation during sprints, enhancing team capabilities and maintaining consistency in configuration practices.</li>
<li>Process Improvement: Contributes to Agile retrospectives to identify opportunities to optimize configuration workflows, tools, or processes within the JIVA system, improving efficiency and quality of sprint deliverables.</li>
<li>Agile Collaboration: Actively participates in Agile ceremonies, including sprint planning, daily standups, sprint reviews, and retrospectives, to foster collaboration and continuous improvement. </li>
</ul>
</li>
<li>30% - Feature Planning
<ul>
<li>Solution Development: Collaborates with Configuration Management Specialist during backlog refinement and sprint planning to design and develop configuration solutions (e.g., assessments, letters, business rules) that meet user story acceptance criteria within the JIVA system.</li>
<li>Initial Request Review: Assesses incoming configuration and enhancement requests during sprint planning to determine feasibility, compatibility with JIVA system capabilities, and resource requirements, providing input for user story sizing.</li>
<li>Sizing and Planning: Participates in Agile ceremonies (e.g., sprint planning, backlog refinement) to size configuration tasks, provide technical insights on feasibility, and helps establish sprint delivery timelines and priorities. </li>
</ul>
</li>
<li>10% - Other
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Do You Have What the Role Requires? 
<ul>
<li>Bachelor's degree in healthcare administration, information technology, business, or a related field PLUS 7 years of experience in application configuration, software development, or clinical systems support, of that, 5 years must be in a healthcare operations 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>5 years of experience with troubleshooting, testing, and documentation in an Agile or Kanban setting required. </li>
<li>5 years of experience with Software Management Applications such as Service Now (SNOW), JIRA, SharePoint required. </li>
<li>3 years of experience in application configuration, software development, or clinical systems support, preferably with the JIVA system required. </li>
</ul>
 You'll Stand Out More If You Possess the Following: 
<ul>
<li>Agile certifications (e.g., Certified Scrum Developer, SAFe Developer). </li>
<li>2 years of JIVA application experience in application configuration, software development. </li>
<li>Experience with vendor coordination and cross-functional Agile team collaboration.</li>
</ul>
 What the Regulatory Agencies Need You to Possess? 
<ul>
<li>n/a</li>
</ul>
 Your Knowledge &amp; Abilities to Bring to this Role: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Your Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Ways We Are Here For You 
<ul>
<li>You'll enjoy competitive compensation for this role.
<ul>
<li>Our current hiring range is: Pay Grade: 314 - $99,902 - $159,843 ($48.03 - $76.8476). 
<ul>
<li>The base pay offered will take into account internal equity and also may vary depending on the candidate's job-related knowledge, skills, and experience among other factors. </li>
</ul>
</li>
</ul>
</li>
<li>This position is approved for Full Telework (**If the position is Telework, it is eligible in California only**) </li>
<li>A <a href="https://apptrkr.com/get_redirect.php?id=6746904&amp;targetURL=https://www.caloptima.org/en/careers#benefits" target="_blank">comprehensive benefits package</a> </li>
<li>CalPERS pension program and additional retirement packages. </li>
<li>Additional benefits and perks including:
<ul>
<li>A generous PTO program</li>
<li>A quality work life balance</li>
<li>Various wellness programs</li>
<li>Tuition Reimbursement</li>
<li>Professional development opportunities</li>
<li>Career development opportunities</li>
<li>Flexible scheduling</li>
<li>And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.</li>
</ul>
</li>
</ul>
 Our Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 Why Join Us? We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare. What's Your Next Step? All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is October 20, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. Our Commitment to You Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet. We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6746904" target="_blank">https://jobs.caloptima.org/jobs/sr-configuration-analyst-its-analyst-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-870ced11d185a24290f10576c444c9aa

245,066 office-manager Jobs