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<p>Salary Range:&nbsp;&nbsp;$105,267.00&nbsp;(Min.) -&nbsp;$139,478.00&nbsp;(Mid.) -&nbsp;$173,689.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Information Technology (I.T.) Infrastructure Project Manager II is responsible for the overall direction, coordination, implementation, execution, control and completion of specific projects ensuring consistency with I.T. Infrastructure strategy, commitments and goals. Facilitate the definition of project scope, goals and deliverables, define project tasks and resource requirements and develop full scale project plans. Provide guidance and track all assigned projects from planning/initiation through delivery. Responsible for managing project budgets, resources (internal/vendor) and timeline through final work product delivery.</p><h4>Duties</h4><p>Provides guidance and overall project direction and support. Leads the project planning, scope definition and execution of project deliverables and timeline.</p><p>Develops, manages and tracks full scale project plans and schedules. Manages changes to project scope and schedule, project change management process and practices.</p><p>Assembles and manages internal and external project resources. Manages project resource allocation, budget and vendor management.&nbsp; </p><p>Analyzes, prepares and manages several reports to streamline communication, methods and process improvement.</p><p>Monitors operational activities, trends and timelines, communication, and coordination of special projects.</p><p>Achieves operational objectives by contributing information and recommendations to strategic plans and reviews.</p><p>Prepares and completes action plans, audits, identifies trends, determines system improvements and implements change.</p><p>Performs other duties as assigned.</p><h4>Duties Continued</h4><h4>Education Required</h4>Bachelor's Degree in Project Management or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4><h4>Experience</h4><p>Required:<br>Minimum of 5 years of demonstrated successful project management experience&nbsp;</p><p>Preferred:<br>Experience working in a Health Care/ Health Maintenance Organization (HMO) Organization</p><h4>Skills</h4><p>Required:</p><p>Ability to work well with many different kinds of people, stakeholders, vendors and all divisions.</p><p>Must be a self-starter, motivated, innovative, able to adapt to priority changes and work hours.&nbsp;</p><p>Working knowledge of MS Office, Visio, project plan.</p><p>Demonstrated ability to be results-driven and accountability-minded.</p><p>Excellent written and verbal communication skills.&nbsp;</p><p>Working knowledge of Jira</p><p>Must be able to persuade business units and I.T. project teams to utilize standard project management best practices established at L.A. Care; also persuade business users on alternate options that ensure that work product delivered is acceptable and meets the documented requirements.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Project Management Professional (PMP)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                </p>

L.A. Care Health Plan

Information Technology Infrastructure Project Manager II

<p>Salary Range:&nbsp;&nbsp;$102,183.00&nbsp;(Min.) -&nbsp;$132,838.00&nbsp;(Mid.) -&nbsp;$163,492.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Managing Advisor, Enterprise Compliance is responsible for managing and overseeing the development and review of organizational policies and procedures. This role includes overseeing the policy and procedure module and administering the full governance, risk, and compliance (GRC) system. The Managing Advisor ensures that all employees complete required compliance training annually, during onboarding, and coordinates training for the Board of Governors. Additional responsibilities include managing the exclusion monitoring process and supervising the ethics hotline and civil rights mailbox, which handle ethical concerns and compliance violations. The manager supports the reporting of compliance functions to the Chief Compliance Officer, Internal Compliance Committee, and the Board of Governors. Furthermore, they conduct research and recommend strategic compliance initiatives to enhance organizational compliance efforts.</p><p>This position plans and manages department's goals and activities to ensure the overall success. Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.</p><h4>Duties</h4><p>Policy and Procedure Management:</p><p>Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities. </p><p>Develop, review, and implement policies and procedures across the organization.</p><p>Manage the policy and procedure module within the enterprise's governance, risk, and compliance (GRC) system.</p><p>Administer the full GRC system to ensure effective compliance management.</p><p>Plans, manages, and executes various program strategies to improve the department's growth that is aligned with the organizational goals.</p><p>Compliance Training:</p><p>Oversee the review and update of all required compliance training.</p><p>Ensure all employees complete required compliance training on an annual basis and during new hire onboarding.</p><p>Coordinate compliance training sessions for the Board of Governors.</p><p>Exclusion Monitoring:</p><p>&nbsp;Manage the exclusion monitoring process to ensure compliance with relevant regulations and standards.</p><p>&nbsp;Reporting for exclusion monitoring results.</p><p>Ethics Hotline and Civil Rights Mailbox:</p><p>Supervise the ethics hotline and civil rights mailbox to handle anonymous submissions related to ethical concerns, compliance violations, and other issues.</p><p>Ensure proper documentation and follow-up on all reported issues.</p><p>Compliance Reporting:</p><p>Support the preparation and reporting of Enterprise compliance activities to the Chief Compliance Officer, Internal Compliance Committee, and the Board of Governors.</p><p>Provide accurate and timely reports related to compliance functions and activities.</p><h4>Duties Continued</h4><p>Strategic Initiatives:</p><p>Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.</p><p>Conduct research, plan, and make recommendations for strategic initiatives aimed at improving the organization’s compliance program and overall governance.</p><p>Team Leadership and Development:</p><p>Manage staff, including, but not limited to monitoring of day-to-day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others.</p><p>Responsible for managing the daily operations of a technical and specialized function.</p><p>Provides guidance to senior management on how to implement change programs within the department that comply with all relevant laws and regulations.&nbsp;&nbsp; </p><p>Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.</p><p>Perform other duties as assigned.</p><h4>Education Required</h4>Bachelor's Degree in Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4><h4>Experience</h4><p>Required:</p><p>At least 5 years of health care or related experience designing, implementing and/or monitoring requirements, policies, and practices, and/or managed health plan/managed care operations.</p><p>At least 3 years of supervising and/or managing staff experience.&nbsp; &nbsp;</p><p>Preferred:</p><p>At least 3+ years of leading staff.</p><h4>Skills</h4><p>Required:</p><p>Strong organizational and planning skills. </p><p>Strong ability to handle multiple assignments, changing priorities, and competing deadlines.</p><p>Sound understanding of regulatory compliance guidelines and policies.</p><p>Proficient verbal, written communication, and presentation skills.</p><p>Effective problem-solving skills and critical thinking ability.</p><p>Strong assessment and interpretation skills. </p><p>Demonstrated ability in relationship-building.</p><p>Effective leadership capability.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                </p>

Managing Advisor, Enterprise Compliance

<p>Salary Range:&nbsp;&nbsp;$110,279.00&nbsp;(Min.) -&nbsp;$146,120.00&nbsp;(Mid.) -&nbsp;$181,961.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Advisor Compliance Policy and Regulatory is responsible for managing, developing, and implementing health compliance strategies to ensure compliance with Medi-Cal regulations and alignment with the organization’s strategic goals. </p><p>This position collaborates with L.A. Care Cabinet members, Compliance team leaders, Compliance and Quality Committee members, governmental agencies, healthcare providers, and community stakeholders to advocate for compliance strategies that improve access, quality, and sustainability of Medi-Cal services, Covered California, and D-SNP. </p><p>Additionally, this position works closely with Cabinet members for ensuring Compliance has appropriate stakeholder engagement and alerts the Chief Compliance Officer of any issues and risks not being addressed or mitigated. The advisor supports the execution of the Annual Compliance Work Plan and provide the necessary support to seek completion of key activities in Compliance. </p><p>This position collaborates with key stakeholders to review programs, projects, processes, procedures, and policies; and to conduct end-to-end root cause analysis to enhance and improve outcomes and remediate issues to comply with the national and statewide standards and regulations.</p><p>Provides expert advice to various teams, including program and product development, marketing, and customer service, on various relevant topics.</p><h4>Duties</h4><p>Develops reports, analyzes data and provides presentation on status of areas of responsibilities on an as needed basis in support of department operations.</p><p>Partners with the management to communicate compliance and operational priorities and provide feedback or follow-ups to key stakeholders.</p><p>Acts as the point of contact for key strategic initiatives.&nbsp; </p><p>Provides expert advice to various business units on relevant topics within the organizational standards, national and state-wide compliance.</p><p>Conducts research and analysis of business performance and improvements with key stakeholders to document current state, identify gaps and present remediation plan/options to leadership.&nbsp; Leads the implementation of initiatives and monitor for successful outcomes.</p><p>Policy Development and Implementation: Lead the development of health policies related to Medi-Cal services, ensuring alignment with state and federal regulations and the mission of the local health plan.</p><p>Regulatory Compliance: Ensure the health plan adheres to Medi-Cal and related healthcare regulatory standards, including timely implementation of legislative and policy changes.</p><p>Advocacy and Representation: Serve as the primary representative for the health plan in discussions with state and federal agencies, including the Department of Health Care Services (DHCS), legislators, and other stakeholders.</p><p>Government Relations: Develop and maintain relationships with key policy-makers and advocacy groups to influence health policy in support of the organization’s goals.</p><p>Strategic Planning: Work closely with the executive leadership team to integrate policy considerations into the organization’s strategic plans, ensuring policies promote improved patient outcomes and operational efficiencies.</p><h4>Duties Continued</h4><p>Stakeholder Engagement: Lead efforts to engage and collaborate with healthcare providers, advocacy groups, and community organizations to support the implementation of Medi-Cal policies.</p><p>Policy Research and Analysis: Oversee research and analysis of emerging health policy trends, legislation, and regulatory changes that could impact the local Medi-Cal plan and its beneficiaries.</p><p>Communication and Education: Ensure clear and consistent communication regarding policy changes and compliance requirements across all levels of the organization, as well as with external partners.</p><p>Leadership and Team Management: Lead a team of policy experts, ensuring effective policy analysis, strategy development, and advocacy efforts are implemented to advance the goals of the health plan.</p><p>Collaboration and Cross-Functional Support: Work closely with Cabinet, Compliance, IT, and other departments to integrate compliance risk management. Provide expert guidance to internal stakeholders on compliance and regulatory policies.</p><p>Reporting and Communication: Develop and deliver regular quarterly reports on stakeholder engagement.</p><p>Communicate cross-departmental compliance risk issues and mitigation plans effectively to both internal and external audiences. Provide updates on Compliance Workplan completeness.</p><p>Perform other duties as assigned.</p><h4>Education Required</h4>Bachelor's Degree in Public Health or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Public Health or Related Field<h4>Experience</h4><p>At least 5 years of experience in healthcare policy, government relations, or regulatory affairs, preferably in a Medi-Cal or Medicaid environment.</p><p>Experience working with state and federal healthcare regulatory agencies.</p><p>Experience and Proven track record of successfully advocating for health policy initiatives.</p><p>Preferred:</p><p>Experience with California’s Medi-Cal programs and public health systems.</p><h4>Skills</h4><p>Required:</p><p>Strong understanding of Medi-Cal regulations, healthcare policy, and public health issues in California.</p><p>Excellent strategic thinking, leadership, and decision-making skills.</p><p>Strong communication and relationship-building abilities, with experience working with diverse stakeholders.</p><p>Ability to navigate complex regulatory environments and advocate effectively for policy change.</p><p>Excellent organization skills.</p><p>Proficiency with Microsoft Office applications (Word, Excel, Access, PowerPoint).</p><p>Ability to collaborate with cross-functional teams and influence decision-making.</p><p>Preferred:</p><p>Established relationships with policymakers,5 regulators, and advocacy groups in the healthcare field.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Public Policy, Risk Management, Public Health, Medicaid, Government, Finance, Healthcare                                                    </p>

Advisor Compliance Policy and Regulatory

<p>Salary Range:&nbsp;&nbsp;$46,800.00&nbsp;(Min.) -&nbsp;$52,597.00&nbsp;(Mid.) -&nbsp;$62,270.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Quality and Population Health Coordinator I (QPHC) is responsible for outreaching to members to close care gaps. The QPHC also outreaches to providers for medical record pursuit and retrieval. The QPHC is an important member of L.A. Care’s quality improvement team, helping to drive improvement in health outcomes, population health, and health equity, as well as member and provider experience.</p><h4>Duties</h4><h4>Make outbound calls to members to assist with scheduling and coordinating services (e.g. appointments, lab tests, health screenings, other diagnostic studies, transportation, etc.). (25%)</h4><h4>Educate members on missing gaps in care. Encourage them to close care gaps and pursue preventative health and health promotion activities. (25%) </h4><h4>Outreach to providers to request medical reports by fax, electronic medical records, or on-site visits if needed. (15%) </h4><h4>Review medical records, claims, and encounter data to identify key information to help close gaps in care. (15%)</h4><h4>Provide support as needed for care gap closure campaigns and other quality improvement programs. (15%)</h4><p>Perform other duties as assigned. (5%)</p><h4>Duties Continued</h4><h4>Education Required</h4>High School Diploma/or High School Equivalency Certificate<h4>Education Preferred</h4>Associate's Degree<h4>Experience</h4><p>Required:</p><p>At least 3 months of experience following basic workflows, procedures, and standards related to patient or provider communication and outreach.</p><p>Previous experience working in an office setting with basic office equipment such as telephones, fax machines, computers, etc.</p><p>Preferred:</p><p>Health Plan, provider practice, or health education experience. </p><h4>Skills</h4><p>Required:</p><p>Demonstrates deep compassion and sensitivity towards patient needs and community well-being. </p><p>Driven by strong motivation to positively impact people’s lives.</p><p>Excellent verbal and written communication skills.</p><p>Excellent interpersonal skills.</p><p>Proficient with Microsoft Word, Excel, PowerPoint, and Outlook.</p><p>Skills in utilizing various online platforms and search engines to efficiently gather accurate and relevant information. </p><p>Highly organized with ability to maintain accurate notes and records.</p><p>Demonstrates high efficiency in managing tasks and consistently delivering projects to successful and reliable completion. </p><p>Ability to communicate effectively with patients and health care providers. </p><p>Preferred:</p><p>Some knowledge of HEDIS and other quality measures.</p><p>Some knowledge of quality improvement processes.</p><p>Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese&nbsp;&nbsp; </p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    EMR, Claims, Medical, Equity, Healthcare, Insurance, Finance                                                    </p>

Quality and Population Health Coordinator I (ALD)

<p>Salary Range:&nbsp;&nbsp;$105,267.00&nbsp;(Min.) -&nbsp;$139,478.00&nbsp;(Mid.) -&nbsp;$173,689.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Enterprise Portfolio Management Office Solutions Analyst III is accountable for intake, execution, and managing the oversight of strategic programs and projects approved and budgeted by L.A. Care Leadership and the Board of Governors. These programs and projects span multiple functions and departments, and are enterprise investments in infrastructure and process excellence. The portfolio, program, and project management resources within the ePMO are uniquely positioned to support business units in the planning and delivery of large-scale programs and projects.</p><p>The Shared Services team within the ePMO operates as a center of excellence for portfolio management, and provides leadership and support in ensuring the ePMO leverages project management best practices when initiating projects, and while monitoring and reporting the status of those projects to project and business leadership. </p><p>Under the general direction of the Manager, and following best practices based on BABOK and other authoritative bodies, the Solutions Analyst is a critical thinker who is responsible for eliciting, analyzing, communicating, testing and verifying functional and non-functional business requirements for strategic initiatives, assisting with the definition of Acceptance Test Criteria, and ensuring requirements are specific, testable, and in alignment with business goals and architecture. The Solutions Analyst works with business and technology resources to temper and align preferences to develop collective and valuable solutions to business needs. This position performs these duties on large, complex projects and programs that require collaboration across many business units. The requirements, solutions and testing for these larger projects require a complete understanding of all impacted processes and work teams. This position is skilled in negotiating between business units to find the best overall solutions and outcomes. </p><p>This position not only works on the complex and difficult projects, but also mentors other analysts both within the ePMO and within the business units, to strengthen L.A. Care's business analysis capability. This very experienced individual also helps to define and implement best practices for solutions and business analysis for the organization, based on industry-standard authorities. The individual is accountable for intake, execution, and managing the oversight of strategic programs and projects approved and budgeted by L.A. Care Leadership and the Board of Governors. These programs and projects span multiple functions and departments, and are enterprise investments in infrastructure and process excellence. The portfolio, program, and project management resources within the ePMO are uniquely positioned to support business units in the planning and delivery of large-scale programs and projects.&nbsp; Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.</p><h4>Duties</h4><p>Leads analysis and requirements gathering sessions on large, complex programs and projects using methodologies such as JAD, JAR, SCRUM, etc., to define, analyze, and document business needs and requirements in support of strategic initiatives. Collaborates across multiple business units ensuring that all parties get the best possible outcomes for L.A. Care and its members and providers. Documents functional and non-functional business needs and requirements, ensuring requirements are usable, specific and testable, and in alignment to business goals and overall business architecture. Assists in defining Acceptance Test Criteria, tracing back to documented business requirements.</p><p>Creates and updates complex as-is and future state business workflows to enable the documentation of business process needs and production of requirements for all related business, and operational systems critical to the project or program. Makes recommendations for solutions or improvements that can be accomplished through new process or technology, or alternative uses of existing processes or technology. Researches and analyzes data in support of business functions, process knowledge, and systems requirements.</p><p>Tracks maintenance of business need and requirements to ensure they are not attenuated or discarded during the execution and delivery phases. Supports the Project Manager by providing more detailed project objectives; clear structured, and useable requirements; tradeoff analysis; requirement feasibility; and risk analysis to improve the execution of the project plan.</p><p>Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable &nbsp;meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed. &nbsp;Mentors other Solutions Analysts and Business Analysts to strengthen L.A. Care's solution and business analysis capability.</p><p>Defines and follows best practices for the organization based on BABOK or other authoritative bodies of knowledge.</p><p>Conducts analysis in support of the entire ePMO.</p><p>Performs other duties as assigned.&nbsp;</p><h4>Duties Continued</h4><h4>Education Required</h4>Bachelor's Degree in Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Related Field<h4>Experience</h4><p>Required:<br>Minimum 5 years of experience eliciting and documenting business and systems requirements using techniques such as JAR/JAD, SCRUM, etc. OR minimum of 5 years of experience developing, implementing, and evaluating workflow processes, policies, and procedures.&nbsp;</p><p>Minimum of 7 years of experience in managed healthcare environment with strong domain expertise in at least one of the following disciplines: Claims/EDI, Membership, Provider, Care Management, or Finance.&nbsp;</p><p>Preferred:<br>Experience with Tableau and Requirements Management software.</p><h4>Skills</h4><p>Required:<br>Proven ability to work with a diverse group of people, including leadership, support staff, coworkers and department management.</p><p>Proven ability to lead cross-functional discussions to reach collaborative outcomes.</p><p>Proven ability to be produce outstanding analysis deliverables on complex, multi-disciplinary projects and programs.</p><p>Demonstrated ability to research complex issues and bring about resolution.</p><p>Demonstrated mentoring and coaching skills to develop other team members.</p><p>Excellent critical thinking and problem solving skills.</p><p>Strong elicitation and process documentation skills.</p><p>Strong organizational and communication skills to build and foster effective relationships.</p><p>Excellent computer skills; MS Office Suite (Word, Excel, Visio, PowerPoint) skills required.</p><p>Excellent customer service skills with the ability to make independent judgments, handle multiple projects simultaneously, adapt to shifting priorities and utilize time management skills to meet deadlines.</p><p>Must have excellent written and verbal communications skills and the ability to communicate effectively with management and non-management personnel.&nbsp;</p><p>Ability to maintain a professional and mature demeanor at all times.</p><p>Ability to work in a fast-paced department independently or in a team, and handle multiple tasks with competing priorities; work with interruptions and deal effectively with confidential information.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Certified ScrumMaster (CSM)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Claims, Insurance                                                    </p>

Enterprise Portfolio Management Office Solutions Analyst III

<p>Salary Range:&nbsp;&nbsp;$77,265.00&nbsp;(Min.) -&nbsp;$100,445.00&nbsp;(Mid.) -&nbsp;$123,625.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Healthcare Effectiveness Data and Information Set (HEDIS) Abstractor II reviews medical records to ensure completeness, compliance with National Committee for Quality Assurance (NCQA), California Department of Health Care Services (DHCS) and other regulatory agencies. Abstracts medical record information and enters data on appropriate HEDIS forms (tool). Makes determinations regarding compliance on records and refers records to supervisor for clarification when needed. Overreads record review performed by Medical Record vendor for accuracy and researches possible additional records to close HEDIS gaps. Conducts audits and provides HEDIS education at provider offices and provides feedback to office staff and providers on documentation, medical record coding, preventative services, member satisfaction.</p><h4>Duties</h4><p>Reviews medical records to ensure completeness, compliance with NCQA, DHCS and other regulatory requirements. Ensure records are complete and compliant to meet all regulatory requirements with 100% accuracy.</p><p>Abstracts medical record information and enters data on HEDIS forms (tool) and over reads medical record review performed by vendors. All received medical record information is abstracted and entered accurately on HEDIS forms. Abstracts an average of 100 records or more per day for multiple measures. Works with other staff members to complete the HEDIS project within the time frame for submission to the auditor, NCQA, and regulatory agencies.</p><p>Identifies compliance issues on records and refers records to supervisor for clarification and approval.</p><p><br>Responsible for accurate and prompt medical record decisions.</p><p>May support schedulers by contacting plan partners or providers for additional information if necessary.</p><p><br>Works with schedulers to help them better understand the medical record requests. Speaks with the office staff/manager/provider to clarify the medical record request as necessary.</p><p>Supports the Lead Medical Record by conducting over reads. Overreads medical record abstractions accurately and documents results in the tools provided in the time frame necessary for reporting HEDIS results. Assists with the preparation of de-identifying records for the audit process.</p><p>Conducts HEDIS audits at provider sites. Abstracts and calculates findings of 100 or more records from the provider office; meets with the office staff, provider to discuss findings; makes appropriate recommendations to improve documentation and data submission pertinent to HEDIS.</p><p>Performs other duties as assigned.</p><h4>Duties Continued</h4><h4>Education Required</h4>Bachelor's Degree in Health Science or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4><h4>Experience</h4><p>Required:<br>A minimum of 3 years of experience in HEDIS abstraction and/or other Quality Improvement, Quality Management experience in a managed healthcare setting.</p><p>Preferred:<br>Experience in outpatient clinic or hospital setting with three years of HEDIS abstraction training in HEDIS measures pertinent to Medicare and Medi-Cal.</p><h4>Skills</h4><p><strong>Required:</strong><br>Strong background in medical terminology, anatomy and physiology.</p><p>Proficient in Microsoft Office (Excel, Word and Outlook).</p><p>Strong communications skills: written, verbal, and interpersonal.</p><p>Understanding of Health Insurance Portability and Accountability Act (HIPAA); Ability to abide by strict confidentiality regulations as defined by HIPAA and company policy.</p><p>Working knowledge of the health record, computer system, and data integrity/processing techniques.</p><p>Must be able to work with providers on documentation and coding.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Medical Coding CertificationAccredited Health Information Technician (AHIA)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Financial Impact: Additional position required due to the impact that the Medicare Star program and Medi-Cal auto-assignment program has on the organization.</p><p>Required:<br>Travel to offsite locations for work.</p><p>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Medical Coding, Medicare, Physiology, Healthcare                                                    </p>

HEDIS Abstractor II (Temporary)

<p>Salary Range:&nbsp;&nbsp;$55,245.00&nbsp;(Min.) -&nbsp;$69,045.00&nbsp;(Mid.) -&nbsp;$82,867.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p><br>The Lead Customer Solution Center Service Representative is responsible for the development of a successful and cohesive Call Center unit, with a high level of productivity to achieve the department's overall performance metrics, and to meet and/or exceed member satisfaction. Assist Call Center Supervisors with the supervision of Member Services Representatives by closely monitoring performance, which includes but not limited to: coaching, mentoring, motivating, counseling, etc. to ensure they are providing optimal customer services and meeting and/or exceeding department goals.&nbsp;Responsible for the daily workflow and leading the work of assigned staff.</p><h4>Duties</h4><p>Leadership of day to day activities of Member Services Representatives, including but not limited to: Providing direction. Monitoring of staff performance including attendance. Handling all questions/issues raised by staff. Recommending process improvement processes. Preparing and analyzing call center statistical reports. Monitoring/Adjusting of skill-sets for consistency. Ensuring quantity/quality is met for overtime. Handle escalated calls. Back-up to calls as needed. Assist Supervisor to ensure that Representatives provide accurate, timely and quality service to our members/providers. Ensure that all departmental policies, procedures and standards are being met, as well as the organization's mission. Assist Supervisor to ensure that deviations in performance are identified in advance and process changes are made to redirect performance to acceptable levels. Assist Supervisor to ensure that we provide accurate, timely and professionally written, statistical and verbal reports to management for historical, current status and forecasting purposes. Assist Supervisor in reviewing the Representatives overall quality accuracy. Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. (40%)</p><p>Trains and motivates staff. Ensures appropriate service standards are developed and maintained. Leads the work of assigned staff; regularly assigns and checks the work of others, providing guidance, training and feedback on performance to department management.&nbsp; Oversees the daily office workflow, develops and recommends enhancements to process and procedures.&nbsp;&nbsp; (5%)</p><p>Work with training staff to ensure that training practices support staffing and performance standards, takes responsibility for identifying on-going training needs and integrating training and performance expectations as well as work closely with Supervisors to create and/or modify Desk top procedures. (5%)</p><p>Work closely with management to review performance and quality standards on an ongoing basis and to assist with development and implementing incentive programs. As well as motivational programs needed to achieve service standards. (10%)</p><p>Ensures that front line service personnel are capturing information and providing feedback to Supervisors that will enable L.A. Care to improve its product and internal process. (10%)</p><h4>Duties Continued</h4><h4>Represents the Department when requested at meetings. Assist Supervisor with meetings and provides necessary feedback when requested. (5%)</h4><h4>Ensure department remains in compliant with HIPAA regulations relating to protected health information (PHI). (10%)</h4><h4>Maintains attendance expectations. (5%)</h4><h4>Perform other duties as assigned. (10%)</h4><h4>Education Required</h4>High School Diploma/or High School Equivalency Certificate<h4>Education Preferred</h4>Associate's Degree<h4>Experience</h4><p>Required:</p><p>At least 2 years of customer service experience.</p><p>At least 6 months of lead experience in a health plan/ healthcare customer service call center environment.</p><p>Preferred:</p><p>Experience in working with the disadvantage population, Covered California, and Cal MediConnect.</p><h4>Skills</h4><p>Required:<br>Must have knowledge in direct line of business.&nbsp;<br><br>Must know Medical Terminology.</p><p>Must have excellent written and verbal communication skills.</p><p>Strong analytical, coaching/mentoring skills, team building.<br><br>Ability to work effectively with diverse team members.<br><br>Must also have the ability to troubleshoot problem areas and recommend effective alternative solutions to handle irate callers, and provide optimal customer service for internal and external customers.</p><p>Must be flexible with time and be able to work overtime including weekends.&nbsp;</p><p>Must be able to multitask and to streamline day to day operations, policies and procedures.</p><p>Must have advance PC skills including Excel and Access.</p><p>Preferred:<br>Bilingual in one of LA Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Call Center Representative, Customer Service Representative, Call Center, Customer Service                                                    </p>

Lead Customer Solution Center Service Representative

<p>Salary Range:&nbsp;&nbsp;$135,136.00&nbsp;(Min.) -&nbsp;$175,676.00&nbsp;(Mid.) -&nbsp;$216,218.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Director, Enterprise Risk Management serves as a leader within the Enterprise department.&nbsp; The Director develops, oversee, and implement an organization-wide Enterprise risk management strategy that ensures the identification, assessment, and mitigation of risks that could negatively impact the organization’s ability to achieve its objectives. The Director evaluates and oversee vendor risks.&nbsp; This position will drive reporting, presentations and education to executives and board members to communicate the status and nature of Enterprise risks at L.A. Care.&nbsp; Additionally, the Director will lead business continuity planning efforts, including emergency response and crisis management. </p><p>This position oversees L.A. Care’s exception management process and other duties that support the mission and responsibilities of the Enterprise department.</p><p>Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.</p><h4>Duties</h4><p>Risk Strategy Development and Implementation:</p><p>Develop and execute a comprehensive Enterprise risk management strategy aligned with the organization's objectives, including the creation of an enterprise annual Enterprise risk assessment.</p><p>Establish policies, frameworks, and processes for identifying, assessing, managing, and mitigating Enterprise risks across all business units, including the establishment and maintenance of enterprise risk tolerance.</p><p>Regularly update Enterprise risk assessments and profiles, presenting findings to the executive team and board of directors.</p><p>Oversee the management of ongoing issues.&nbsp; Work with internal audit, legal, and Enterprise teams to address any organizational, regulatory or Enterprise risks.</p><p>Business Continuity Planning (BCP):</p><p>Lead the development and maintenance of the organization's Enterprise risk management business continuity plan.</p><p>Coordinate Enterprise risk management business impact analyses (BIAs) to identify critical business functions and resources.</p><p>Ensure regular testing and updating of business continuity and disaster recovery plans to minimize disruption during emergencies.</p><p>Provide training and guidance to departments on Enterprise risk management business continuity best practices.</p><p>Exceptions Management:</p><p>Establish an exceptions management process for handling Enterprise risk management deviations from established policies.</p><p>Review and evaluate Enterprise risk exceptions requests, ensuring they are justified, documented, and aligned with organizational risk tolerance.</p><p>Collaborate with business leaders to assess the potential impact of exceptions and implement compensating controls as needed.</p><h4>Duties Continued</h4><p>Vendor Risk Oversight:</p><p>Lead and oversee a comprehensive vendor risk management program to assess and monitor risks related to third-party relationships.</p><p>Oversee vendor due diligence processes, including risk assessments, contract reviews, and performance monitoring.</p><p>Ensure vendors comply with regulatory requirements and internal security and risk policies.</p><p>Monitor and mitigate potential risks arising from third-party vendors, ensuring they meet the organization’s risk and Enterprise standards.</p><p>Risk Monitoring and Reporting:</p><p>Establish key risk indicators (KRIs) and develop dashboards to monitor risk exposure across the organization.</p><p>Prepare and present regular reports to executive leadership on risk status, emerging threats, and mitigation strategies.</p><p>Provide timely risk assessments and recommendations to senior leadership for informed decision-making.</p><p>Team Leadership and Development:</p><p>Manage staff, including, but not limited to monitoring of day-to-day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others.</p><p>Collaborate cross-functionally with business units to embed risk management into day-to-day decision-making.</p><p>Perform other duties as assigned.</p><h4>Education Required</h4>Bachelor's Degree in Healthcare Management, Public Health, Business, Health Administration or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree<h4>Experience</h4><p>At least 7 years of experience in risk management, including experience in business continuity planning and vendor risk management.</p><p>At least 5 years of experience of leading, supervising and/or managing staff.</p><p>Demonstrated ability and experience in ensuring adherence to legal and ethical standards within the organization.</p><h4>Skills</h4><p>Required:</p><p>Proven Leadership with the ability to manage cross-functional teams and drive organizational change.</p><p>Excellent analytical, problem solving, and decision-making skills.</p><p>Strong communication skills with the ability to present complex risk concepts to executive leadership and board members.</p><p>Strong ability to organize tasks, managing timelines and allocating resources to complete projects successfully.</p><p>Demonstrated ability to respond quickly to changing circumstances and adapting to new situations.</p><p>Demonstrated ability and understanding of financial statements and making informed business decisions based on financial data.</p><p>Preferred:</p><p>Strong knowledge of risk management frameworks, regulatory requirements, and best practices</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Certification Risk Management Professional (CRMP) or equivalent<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Risk Management, Internal Audit, Public Health, Finance, Healthcare                                                    </p>

Director, Enterprise Risk Management

<p>Salary Range:&nbsp;&nbsp;$110,279.00&nbsp;(Min.) -&nbsp;$146,120.00&nbsp;(Mid.) -&nbsp;$181,961.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Advisor Vendor Risk Oversight reports to the Director of Risk Management and is responsible for leading and managing the organization’s vendor risk management program to ensure that third-party vendors meet compliance, security, and performance standards. This role focuses on identifying, assessing, mitigating, and monitoring risks associated with external vendors across all business functions. The Advisor will collaborate with internal stakeholders to ensure vendor-related risks are effectively managed and aligned with the organization’s risk appetite and regulatory requirements.</p><p>This position collaborates with key stakeholders to review programs, projects, processes, procedures, and policies; and to conduct end-to-end root cause analysis to enhance and improve outcomes and remediate issues to comply with the national and statewide standards and regulations.</p><p>Provides expert advice to various teams, including program and product development, marketing, and customer service, on various relevant topics.</p><h4>Duties</h4><p>Vendor Risk Management Program Leadership:&nbsp; Develop, implement, and continuously enhance the vendor risk management framework, policies, and processes.&nbsp; Oversee the risk assessment and due diligence of new and existing vendors, ensuring alignment with regulatory requirements and internal risk policies.&nbsp; Establish risk metrics, performance standards, and vendor and spend category risk scorecards to monitor vendor compliance and risk levels.</p><p>Risk Identification and Assessment:&nbsp; Lead the evaluation and risk categorization of vendors based on factors such as data security, financial risk, membership impact, operational reliability, and compliance with regulatory requirements.&nbsp;&nbsp; Conduct vendor risk assessments, including reviewing contracts, service level agreements (SLAs), spend category strategies and other relevant documentation to identify potential risks.</p><p>Mitigation and Monitoring: &nbsp;Collaborate with internal stakeholders to develop and implement risk mitigation strategies for high-risk vendors and spend categories.&nbsp; Monitor vendor performance and risk exposure continuously, using data analytics and reporting to track changes in vendor risk profiles.&nbsp; Ensure timely identification and escalation of issues related to vendor non-compliance or performance failures.</p><p>Third-Party Risk Governance:&nbsp; Lead governance activities related to vendor risk oversight, including organizing vendor risk committee meetings, and preparing reports for senior leadership and other stakeholders.&nbsp; Ensure the organization’s vendor risk management program complies with all relevant regulatory requirements and industry best practices.</p><p>Vendor Compliance:&nbsp; Coordinate with internal audit and compliance teams to address vendor-related findings and ensure timely resolution of any identified issues and corrective action plans.</p><p>Collaboration and Cross-Functional Support: Work closely with internal stakeholders to integrate vendor risk management into procurement and contracting processes.&nbsp; Provide expert guidance and training to internal stakeholders on vendor risk management best practices and policies.&nbsp; Leverage vendor and spend management tools (e.g. Ariba/SAP) and collaborate with procurement to incorporate risk elements into vendor and spend category analysis.</p><h4>Duties Continued</h4><p>Reporting and Communication:&nbsp; Develop and deliver regular reports on vendor risk exposure, performance, and compliance to senior management and other stakeholders.&nbsp; Communicate vendor-related risk issues and mitigation plans effectively to both internal and external audiences.</p><h4>Develops reports, analyzes data, and provides presentation on status of areas of responsibilities on an as needed basis in support of department operations.</h4><h4>Partners with the management to communicate compliance and operational priorities and provide feedback or follow-ups to key stakeholders.</h4><h4>Acts as the point of contact for key strategic initiatives.&nbsp; </h4><h4>Provides expert advice to various business units on relevant topics within the organizational standards, national and state-wide compliance.</h4><h4>Conducts research and analysis of business performance and improvements with key stakeholders to document current state, identify gaps and present remediation plan/options to leadership.&nbsp; Leads the implementation of initiatives and monitor for successful outcomes.</h4><p>Perform other duties as assigned.</p><h4>Education Required</h4>Bachelor's Degree in Healthcare Management, Public Health, Business, Health Administration or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4><h4>Experience</h4><p>At least 5 years of experience in vendor risk management, procurement or vendor relationship management, third-party risk management or related risk oversight roles.</p><p>Experience with risk assessment methodologies and tools.</p><p>Procurement or Vendor Management experience.</p><p>Experience with procurement and vendor analysis tools, ideally Ariba/SAP.</p><h4>Skills</h4><p>Required:</p><p>Excellent analytical, communication, written, and project management skills.</p><p>Ability to collaborate with cross-functional teams and influence decision-making.</p><p>Excellent organization skills.</p><p>Excellent understanding of regulatory requirements.</p><p>Proficiency with Microsoft Office applications (Word, Excel, Access, PowerPoint).</p><p>Preferred:</p><p>Strong knowledge of regulatory requirements related to third party risk management</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Certification Risk Management Professional (CRMP) or equivalent<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>This position may require occasional travel to vendor sites and the ability to manage multiple time-sensitive projects.</p><p>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Risk Management, Internal Audit, Relationship Manager, Public Health, Finance, Customer Service, Healthcare                                                    </p>

Advisor Vendor Risk Oversight

<p>Salary Range:&nbsp;&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Manager, SQL and Oracle Database will lead and manage projects. This position will manage a team of skilled database administrators and developers in the design, implementation, and support of both Microsoft SQL and Oracle database systems. The focus is on the Microsoft SQL Technology Platform, including SQL Server Databases, Applications, and Reporting environments, as well as the Oracle Technology Platform, including Oracle Databases, Applications, and Data Warehouse environments.</p><p>The Manager ensures optimal design and performance through creative problem-solving and effective communication. &nbsp;&nbsp;The Manager prioritizes work independently, manages multiple projects, and thrives in a dynamic environment while maintaining a service-oriented attitude. </p><p>Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.</p><h4>Duties</h4><p>Develop and manage the guidelines and Standard Operating Procedures (SOPs), ensuring consistency and efficiency in database management practices. Design and implement new applications and disaster recovery solutions for a diverse group of databases.</p><p>Establish and oversee procedures for maintaining database security, ensuring robust protection measures are in place. Manage database capacity planning, record archival, and regular monitoring of storage to optimize performance and prevent issues. Supervise the implementation and management of database software upgrades and patching to keep systems up to date and secure.</p><p>Manage teams that support systems using Oracle and Microsoft SQL technologies. Oversee and collaborate in the development and enforcement of standards for effectively managing relational database management systems (RDBMS). Work closely with key internal and external stakeholders to provide architectural guidance for on premise, cloud, and hybrid environments. Collaborate with Project Managers to properly scope, plan, execute project to completion. Assist with daily operations, including overseeing timesheet management, resolving support tickets, and managing work allocation.</p><p>Manage and guide team members to deliver tier 2 and 3 support for all corporate Oracle and SQL Server databases, ensuring compliance with service level agreements. Supervise the development, installation, maintenance, and monitoring of company databases to maintain high performance and availability, supporting enterprise-wide projects. Ensure robust database design, implementation, and management to provide reliable and consistent I.T. services.</p><p>Ensure comprehensive documentation of database specifications, licensing, configurations, and infrastructure. Develop and enforce processes, procedures, and guidelines for effective troubleshooting and task execution.</p><p>Evaluate production issues and new project requirements, working closely with cross-functional teams to find timely solutions and improve system reliability.</p><h4>Duties Continued</h4><h4>Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.</h4><h4>Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.</h4><h4>Develop goals, objectives and actions plans for assigned staff.&nbsp; </h4><h4>Perform other duties as assigned.</h4><h4>Education Required</h4>Bachelor's Degree in Computer Science or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Computer Science or Related Field<h4>Experience</h4><p>Required:</p><p>At least 6 years of extensive and broad-based experience in the design, administration, and support of SQL and Oracle Server databases in one or more client-server environments (e.g., LINUX, UNIX).</p><p>At least 4 years of leading, managing and/or supervising staff.</p><p>In-Depth experience of latest version of SQL and Oracle.</p><p>Experience in resource planning/management and source control.</p><p>Experience in working with mission-critical applications that require 24/7 uptime.</p><p>Experience in consolidating and virtualizing environments.</p><p>Experience in building and maintaining DEV, QA, UAT, PROD, and Disaster Recovery environments.</p><p>Strong experience performing Oracle Database installations, upgrades, and patch installations.</p><p>Preferred:</p><p>Experience in working within a Health Care Health Maintenance Organization (HMO) in a similar capacity.</p><h4>Skills</h4><p>Required:</p><p>Expertise in designing and implementing new applications and disaster recovery solutions for a diverse group of databases.</p><p>Excellent interpersonal, verbal and written communication skills.&nbsp; Ability to communicate information and issues clearly and succinctly with both technical and non-technical personnel.</p><p>Excellent presentation skills to train, and convey technical information simply and understandably to department staff and administrators.</p><p>Strong leadership capabilities.&nbsp; Effective self-management in completing systems and database-related projects independently, on a team, and while leading a team.</p><p>Demonstrates initiative and attention to detail. Ability to quickly adapt to and learn unfamiliar technologies.</p><p>Decisive decision-making abilities.</p><p>Ability to work flexible hours as required by business priorities.&nbsp; Ability to thrive in a changing environment.</p><p>Ability to work under stressful and chaotic circumstances.</p><p>Ability to manage multiple projects with multiple priorities.</p><p>Strong knowledge of database backup and recovery using RMAN backups.</p><p>Proficient in troubleshooting issues and quickly resolving them efficiently to minimize downtime.</p><p>Demonstrated ability in resolving a wide range of issues in imaginative as well as practical ways.</p><p>Advanced analytical abilities.&nbsp; Creative problem-solving abilities.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Oracle Certified Expert (OCE): Oracle Database Performance Management and TuningOracle Certified Master (OCM): Oracle Database AdministratorOracle Certified Professional (OCP): Oracle Database AdministratorMicrosoft Certified: Azure Database Administrator AssociateMicrosoft Certified: Azure Solutions Architect ExpertMicrosoft Certified: Data Engineer AssociateMicrosoft Certified: Database Administrator AssociateAWS Certified Database – SpecialtyInformation Technology Infrastructure Library (ITIL) Certification<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Additional Required and Preferred Skills:</p><p>High competency in risk assessment and management.</p><p>Fully versed in logical data modeling and translating it into physical database design.</p><p>Understanding and application of system management, performance timing, and troubleshooting techniques.</p><p>Thorough knowledge of all types of SQL Server replication, clustering, partitioning, and mirroring.</p><p>Strong understanding of the software development lifecycle and software development methodologies (requirements gathering, analysis and design, development tools, version control, testing and QA, and deployment).</p><p>Preferred:</p><p>Knowledge of other databases such as Microsoft SQL Server, MySQL, PostgreSQL, and oracle</p><p>Use skills as a seasoned, experienced professional with a full understanding of industry practices and company policies and procedures.</p><p>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Performance Management, Human Resources                                                    </p>

86 L.A. Care Health Plan Jobs