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<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 Senior Manager, Compliance Delegation Oversight is a solutions-oriented, strategic thinker with expertise in change management, process improvement, and developing compliance strategies that enhance daily operations. The Senior Manager is responsible for overseeing key Compliance Delegation Oversight functions, including but not limited to, a Governance/Oversight team and Delegate/FDR communication teams. </p><p>The Senior Manager will work closely with cross-functional units/ departments involved in oversight activities.&nbsp; to mature delegation oversight practices. This position is responsible for identifying compliance and performance risks, enhancing the monitoring and auditing processes, and establishing mitigation strategies to ensure compliance with regulatory and accrediting agencies.</p><p>As a key partner to the cross-functional departments, the Senior Manager will lead efforts to identify trends, close gaps, and drive continuous process improvement. They will implement industry-leading practices while leveraging change management techniques to ensure smooth adoption and operationalization. Additionally, the Senior Manager will apply a strong technology acumen to develop scalable, repeatable processes that drive operational efficiency. Serving as the central point of contact for delegate compliance issues, they will manage, escalate, and resolve performance issues, while collaborating with the Delegation Oversight Committee, Vendor Risk Management Committee, and Senior leadership. The Senior Manager will also support other delegate and regulatory operations/compliance activities that may involve delegates/FDRs.</p><p>This position manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.</p><h4>Duties</h4><p>Strategic Leadership, Team Management, and Professional Development:</p><p>Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.&nbsp; Provide strategic direction and leadership to the team, ensuring alignment with organizational goals and objectives.</p><p>&nbsp;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. Foster a culture of continuous learning and growth by mentoring, coaching, and developing staff on best practices, compliance tools, and emerging industry trends. Ensure team members have the resources and support necessary to achieve professional development goals and enhance their contributions to organizational success.</p><p>Operational Excellence and Process Enhancement:</p><p>Oversee day-to-day operations, driving operational efficiency and effectiveness to meet and exceed performance targets. Draft and refine comprehensive process maps, policies, procedures, and guidance documents, optimizing team functions for maximum productivity. Champion process improvement initiatives, leveraging best practices to streamline workflows and enhance overall standardized and repeatable operational outcomes.</p><p>Change Management and Program Development:</p><p>Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. Lead change management efforts for the implementation of new programs, systems, or policies across the team, ensuring that changes are adopted efficiently and effectively. Design and implement training and communication strategies to support staff and stakeholders during transitions.</p><p>Cross-Functional Collaboration and Leadership:</p><p>Play a pivotal role/lead in inter-departmental collaborations and workgroups/committees, leading and facilitating discussions to achieve cross-functional alignment. Prepare, support, and deliver engaging presentations, reports, and data-driven recommendations in various settings. Serve as a key liaison between departments, fostering seamless communication and collaboration for successful project execution.</p><h4>Duties Continued</h4><p>Regulatory Expertise and Compliance Oversight:</p><p>Stay at the forefront of regulatory changes and industry leading practices, analyzing and being a change agent to drive implementation of new and revised applicable regulations, laws, and sub-regulatory guidance from state and federal agencies. </p><p>Risk Management, Vendor Oversight, and Performance Monitoring:</p><p>Lead risk management efforts by overseeing compliance and operational risks related to vendors, delegates, and third-party service providers. Ensure alignment with regulatory and organizational standards while fostering strong vendor relationships. Oversee performance monitoring activities, including audits, to ensure continuous improvement and compliance. Collaborate with cross-functional teams to address any identified issues and implement necessary corrective actions.</p><p>Technology Integration and Data-Driven Decision Making:</p><p>Leverage data analytics and emerging technologies to optimize processes and enhance decision-making capabilities. Drive the adoption of technology solutions to automate compliance tracking, reporting, and operational processes, ensuring scalability and repeatability in execution.Compliance and Quality Assurance:Ensure adherence to organizational, contractual, regulatory, and accreditation standards relevant to the team's functions. Implement and maintain robust quality assurance processes that consistently meet and exceed compliance requirements, ensuring all operations align with the latest regulatory guidelines and best practices.</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 in Healthcare Management, Public Health, Business, Health Administration or Related Field<h4>Experience</h4><p>Required:</p><p>At least 6 years of healthcare experience in designing, redesigning, and implementing compliance programs, policies, and managed care operations, including Medicare, Medicaid, and commercial health plans. Proven ability to develop scalable compliance strategies that mitigate risks, optimize processes, and ensure regulatory adherence across complex healthcare environments.</p><p>At least 4 years of experience leading, supervising and/or managing teams and staff, with a strong focus on coaching and mentoring to ensure adoption of leading practices in industry tools, technology, and compliance approaches. </p><p>Proven experience in change management and operational process improvement, focused on driving sustainable, repeatable processes through well-defined process maps, robust governance structures, and comprehensive supporting documentation to ensure long-term implementation success.</p><p>Proven experience and ability in identifying and managing regulatory/compliance risks and issues, developing corrective action plans, and implementing compliance monitoring systems to track issues through remediation. Skilled in generating regular compliance reports for executive leadership and using data-driven insights to drive continuous improvements. </p><p>Experience working with regulatory agencies and cross-functional teams, including legal, finance, operations, and IT, to align compliance initiatives (e.g., implement new/updated regulations) with broader organizational goals. </p><p>Experience leveraging technology to enhance compliance tracking, reporting, and operational processes. </p><p>Proven experience with Governance, Risk, and Compliance (GRC) tools and collaborative tools to manage projects, perform analytics, and scale processes.</p><p>Extensive experience in creating executive-level reports and analyzing data using Microsoft applications such as Microsoft office Suite, SharePoint, Smartsheet, Tableau, Alteryx/SQL, and/or other applicable tools.</p><p>Preferred: Extensive experience in healthcare consulting or relevant advisory experience, with a track record of delivering scalable and innovative solutions in dynamic environments and recognized as a strong collaborative partner who works effectively across teams and functions.</p><h4>Skills</h4><p>Required:</p><p>Strong expertise in developing, redesigning, and implementing compliance programs, policies, and practices within healthcare organizations.</p><p>Demonstrated ability to engage with regulators, auditors, and external stakeholders to ensure compliance transparency and ongoing success.</p><p>Proven ability to drive team performance, foster professional development, and align staff with organizational objectives.</p><p>Skilled in integrating technology solutions into compliance programs to improve overall effectiveness and scalability.</p><p>Proven ability to interpret and implement complex regulations, ensuring organizational adherence and mitigating compliance risks. </p><p>Advanced Knowledge of regulatory compliance and regulations across multiple lines, including Centers for Medicare and Medicaid Services (CMS), Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), and other governing bodies.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Certified HealthCare Compliance (CHC)Certified in Healthcare Compliance Fellow (CHC-F)Certified Compliance &amp; Ethics Professional (CCEP)Project Management Professional (PMP)Lean Six Sigma<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Additional Required Skills:</p><p>Strong background in managed health plan/managed care business operations, including Medicare, Medicaid, and commercial regulations.</p><p>Demonstrated ability to stay organized, manage multiple projects simultaneously, and utilize project management tools to ensure teams are aligned, deadlines are met, and goals are achieved efficiently.</p><p>Proven ability to coach, mentor, and train teams, fostering skill development, growth, and high performance.</p><p>Skilled in leading change management initiatives that drive operational improvements, sustainability, and process efficiencies.</p><p>Advanced ability to design and implement process maps, policies, procedures, and tools that improve operational efficiency and scalability.</p><p>Expertise in using Governance, Risk and Compliance (GRC) tools for risk management, stakeholder engagement, reporting, and process scaling.</p><p>Strong focus on leveraging data and technology to optimize processes, analyze performance, and drive decision-making.</p><p>Proficient in collaborative and reporting tools such as SharePoint, Smartsheet, Tableau, Alteryx, and SQL for data analysis, reporting, and process optimization.</p><p>Adept at presenting complex data insights clearly and concisely to support informed decision-making at the leadership level. Skilled in using advanced Microsoft tools for data visualization, analysis, and reporting to drive strategic initiatives.</p><p>Adept at designing scalable processes that drive efficiency and long-term success.</p><p>A self-starter who thrives in fast-paced, ever-changing environments, known for innovation and adaptability.</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, Healthcare Consultant, Medicaid, Medicare, Public Health, Finance, Healthcare                                                    </p>

L.A. Care Health Plan

Senior Manager, Compliance Delegation Oversight

<p>Salary Range:&nbsp;&nbsp;$45,760.00&nbsp;(Min.) -&nbsp;$45,760.00&nbsp;(Mid.) -&nbsp;$52,024.00&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 Claims Assistant supports the handling and routing of all documents received through the claims mailroom and the scanning of all paper claims into an electronic format. The Claims Assistant is responsible for opening, accurately counting, sorting the claims by claim type and prepping the claims for scanning. This position assists with scanning of all paper claims and documents into an electronic format. The Claims Assistant enters data for tracking.</p><h4>Duties</h4><p>Processes incoming mail: Opens and dates stamp the mail; Sorts and counts mail receipts; Scans claims into electronic document; Tracks claims receipts and apprises the department manager of high volumes; Forwards misdirected mail to the correct entity; Ensures paper claims and nonstandard documents are routed appropriately to our Plan Partners and internal departments within the required timeframe. All incoming mail are counted, date stamped, and given to the correct party within 24 hours of receipt. (55%)</p><p>Photocopies and mails correspondence to internal departments, Plan Partners, submitting providers, Participating Physician Groups (PPGs), members, and other parties on a daily basis. Scan/ Optical Character recognition (OCR) of paper claims and verification process. Dispositions of mail and claims within 3 to 5 working days of receipt by the department. Scanned/OCR'd claims data has been verified against the document images. (15%)</p><p>Maintains the filing system within the department. All claim related information must be filed within seven working days. Files will be monitored to coordinate moving information to off-site storage. (10%)</p><p>Answers phone inquiries, provides clerical assistance to the claims department as needed, and orders supplies. Determines workloads and process flows to ensure compliance with the regulatory agencies. (10%)</p><p>Performs other duties as assigned. (10%)</p><h4>Duties Continued</h4><h4>Education Required</h4>High School Diploma/or High School Equivalency Certificate<h4>Education Preferred</h4><h4>Experience</h4><p><br>Required:</p><p>At least 6 months of mailroom, data entry and clerical experience in a healthcare/managed care environment.</p><h4>Skills</h4><p><br>Required:</p><p>Must be very detail oriented with the ability to count accurately and track claim documents throughout the mailroom process. </p><p>Proficient in Microsoft Excel with ability to create calculations and charts.</p><p>Must be proficient in using Microsoft Word.</p><p>Must be able to work effectively within the mailroom by mentoring and coaching mailroom staff on correct procedures.</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>Medical, Dental and Vision</li><li>Wellness Program</li><li>Paid Sick Leave</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Claims, Data Entry, Clerical, Insurance, Administrative                                                    </p>

Claims Assistant (Temporary)

<p>Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&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 Financial Compliance Auditor III Claims is responsible for various tasks within the Financial Compliance Unit, including audit of claims processed by medical groups and health plans contracted with L.A. Care. This role works closely with the Supervisor and/or Lead Auditor on identification and resolution of issues in a timely and efficient manner. For Claims Emphasis: This position is responsible for all aspects of assigned claim audits, including audit testing and completion of the audit report. This position is responsible for a variety of complex areas of the Medi-Cal, Medicare, Covered California, and PASC-SEIU benefit and process. This position audits focuses on contractual and regulatory compliance with timeliness and appropriateness standards. This position is responsible for other ongoing tasks as assigned by the Manager of Financial Compliance. These assignments may include claims data reporting in the Online Monitor Tool (OMT), compiling Monthly Timeliness Report (MTR), completion of the financial statement analysis, and Plan Partner oversight of their Independent Practice Association (IPA) network on a quarterly &amp;&nbsp;annual basis.</p><p>Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.</p><h4>Duties</h4><p>Perform auditing procedures under minimal supervision during the&nbsp; audits of medical groups and health plans. Provide timely and accurate reports that detail whether medical groups and health plans are meeting certain regulatory and contractual requirements. Communicate issues and findings that would affect the audit results.</p><p>Perform claims audits for all medical groups and health plans contracted with L.A. Care. Timely audit reports presented to supervisor with one week of the audit date. Communicate issues and findings that would affect the audit results.</p><p>Perform analysis of medical groups and plan partners.</p><p>Set up financial audit work papers. Perform certain administrative functions for the audit team. Set up completely and timely work papers needed prior to going on site for the claims audits.</p><p>Perform other duties as assigned.</p><h4>Duties Continued</h4><h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree<h4>Experience</h4><p>Required:<br>A minimum of 5 years of experience performing claims audits or claims processing related to Medi-Cal, Cal MediConnect, and/or other managed care product lines similar to L.A. Care’s, L.A. Care Covered, and PASC-SEIU programs.</p><h4>Skills</h4><p><br>Required:<br>Must be self-motivated.</p><p>Detail-oriented.</p><p>Able to prioritize assignments, and able to work as part of a team.</p><p>Excellent verbal and written communication skills.</p><p>Ability to interface professionally with both internal and external customers at all levels of the organization.</p><p>Must also have flexible mode of transportation for considerable amount of travel to work off-site.</p><p>Knowledge and understanding of legislation and regulatory bodies affecting healthcare practices.</p><p>Knowledge of medical records systems applications.</p><p>Knowledge of the insurance industry's trends, directions, major issues, regulatory considerations and trendsetters.</p><p>Knowledge of health insurance products, market segments and marketplaces.</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>Delegates:&nbsp; This position also conducts sub-delegation claims oversight audit of the PPGs, capitated hospitals and the Plan Partners. This includes all claims processing sub-contracting functions of the delegates.</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>                    Claims, Audit, Medicare, Financial, Insurance, Finance, Healthcare                                                    </p>

Financial Compliance Auditor III Claims

<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 Business Insights Data Analyst II is responsible for supporting short and long term operational and/or strategic business initiatives. This role develops, enhances, and maintains operational information and models that will have an impact on business decisions. Through the application of data analytics, joining disparate data sources, and working with raw data, this role works to deliver valuable insights and recommendations to improve operational performance.</p><p>This position works in a highly matrixed environment, working closely with senior leaders, management, and line staff to understand root cause, propose recommendations for improvement, and develop solutions on key business challenges.</p><h4>Duties</h4><p>Completes work in a technical and systematic way, using the standard formulas and methods as are common in the industry and relevant to the current data. Collects, manipulates and analyzes data. Guards and protects the organization's data, making sure the data repositories produce consistent, reusable data. </p><p>Prepares reports, which may be in the form of visualizations such as graphs, charts and dashboards, detailing the significant results they deduced. Performs basic statistics such as variations and averages. Predicts yields and/or creates and interprets histograms. &nbsp;</p><p>Influences management and line staff with recommendations generated from data analysis. Drives initiatives to completion working in a highly matrixed environment. </p><p>Performs other duties as assigned.&nbsp; </p><h4>Duties Continued</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<h4>Experience</h4><p>Required:</p><p>At least 3 years of collecting, manipulating, and analyzing data in business and/or finance.</p><p>Preferred: &nbsp;<br>Agile experience.</p><p>SAS software experience.</p><h4>Skills</h4><p><strong>Required:&nbsp;</strong><br>Working knowledge of relational databases, database structures.</p><p>Ability to communicate analysis including trends and opportunities to clients and the business in writing and verbally, includes strong presentation skills.</p><p>Ability to problem solve, manage multiple priorities and research conflicting and/or inaccurate data.</p><p>Strong interpersonal skills, including the ability to influence management at various levels of the organization.</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>

Business Insights Data Analyst II

<p>Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&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 Media Relations Specialist III is responsible for strategizing, leading, developing, and implementing a broad range of public relations activities in support of the organization’s mission, vision, values, and priorities. The Specialist manages the work of the contracted Public Relations agency and leads the account representative on the projects/programs/initiatives for which L.A. Care is seeking attention. The Specialist also manages communication between the organization and media outlets to elevate the organization’s corporate profile and enhance its public perception, serves as the main point of contact for the media, and ensures media relations initiatives are consistent with strategic organization objectives.</p><p>The Specialist collaborates with the social media team, providing content, such as media placements, press releases, news items, and provides input on social media campaigns. The Specialist develops and disseminates messaging and executes media campaigns that position L.A. Care as an innovative healthcare leader in Los Angeles, California, and the national healthcare arena and manages multiple writing assignments and deliverables. The Media Specialist III acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.</p><h4>Duties</h4><p>Establish and cultivate relationships with media, including reporters, editors, podcasters, and bloggers, in order to successfully increase the positive profile of L.A. Care.</p><p>Respond to media inquiries by vetting the request and sourcing the appropriate subject matter expert for comment; coordinate and schedule the interviews.</p><p>Proactively pitch media on positive stories about L.A. Care and its programs/projects/initiatives and product lines.</p><p>Proactively seek out story ideas across multiple departments within L.A. Care.</p><p>Collaborate with internal and external stakeholders, including plan partners and Community Resource Center staff to identify potential stories to pitch.</p><p>Hold a minimum of weekly meetings with the contracted Public Relations agency.</p><p>Maintain and update internal media lists and manage contracts with the Public Relations agency and other media vendors.</p><p>Develop and edit materials to facilitate communications with various external audiences. Responsible for calendar management to ensure materials are completed in time to meet media sensitive timelines. These materials include, but are not limited to, press releases, media statements, key messaging, and talking points for initiatives/projects/events.</p><p>Write executive bylined articles, op-eds, blogs, etc.</p><p>Develop holding statements and talking points in crisis management situations.</p><p>Support Director on issues management, as needed. Represent Director or L.A. Care in meetings or on coalitions related to external communications matters, as needed.</p><p>Use phone or other available equipment to shoot video at L.A. Care-hosted events and ensure the clips and relevant information are provided to news outlets, which were unable to attend the event.</p><p>Ensure all broadcast clips are ordered from the clipping services to share with all appropriate stakeholders.</p><p>Purchase, gather, and upload all news placements (broadcast, print, online) to the website newsroom.</p><p>Produce questions for interviews conducted by internal video production team, and conduct interviews, if needed.<br></p><h4>Duties Continued</h4><p>Coordinate and execute media events, and manage media at all L.A. Care events. Media events will be produced seamlessly and will garner positive attendance and coverage.</p><p>Communicate with top leaders at the health plan in order to coordinate media opportunities. Provide leaders with key talking points, if needed, to ensure a successful interview.</p><p>Provide media training and public speaking preparation for Chief Executive Officer (CEO) , other members of the leadership team, and other staff, when appropriate. Media trainings provided for Leadership Group and Management Team; expanded speaking engagement opportunities for both.</p><p>Apply subject expertise in evaluating business operations and processes. Identify areas where technical solutions would improve business performance. Consult across business operations, providing mentorship, and contributing specialized knowledge. Ensure that the facts and details are correct so that the project’s/program's deliverable &nbsp;meet the needs of the department, organization and legislation's policies, standards, and best practices. Provide training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.</p><p>Mentor other members of the Communications Department on media and public relations issues/protocols.</p><p>Perform other duties as assigned.</p><h4>Education Required</h4>Bachelor's Degree in Communications or JournalismIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Communications or Journalism<h4>Experience</h4><p>Required:<br>At least 5 years of relevant and increasing responsibility, experience on the list of stated knowledge and skills.</p><p>Preferred:<br>Experience within a healthcare organization, nonprofit, or public agency. An understanding of Medi-Cal, Medicare, and related public health programs, and the diverse community L.A. Care serves is a plus.</p><h4>Skills</h4><p>Required:<br>Existing relationships with regional, community, ethnic, and health industry journalists.</p><p>Superior writing, editing, and interpersonal skills.</p><p>Superior research and information gathering skills.</p><p>Ability to quickly and concisely draft a wide range of high-quality materials.</p><p>Ability to manage public relations vendors.</p><p>Ability to interview internal and external subjects, including C-level executives.</p><p>Deep understanding of current events, with an ability to determine whether they are relevant to L.A. Care</p><p>Demonstrated ability to handle multiple projects at once and on deadline.</p><p>Proficiency with Microsoft Office (Word, Excel, Access, PowerPoint).</p><p>Persuasion Skills: Persuade media to do positive stories about L.A. Care and to thwart negative stories, Persuade media to consider L.A. Care executives as thought leaders and expert sources on healthcare-related topics.</p><p>Deep understanding of current social media trends and opportunities.</p><p>Preferred:<br>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.</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>Financial Impact: Salary and benefits; expenses (research materials, collateral materials that may be outsourced, media list and distribution vendors)</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>                    Medicare, Public Health, Healthcare                                                    </p>

Media Relations Specialist III

<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>The Transitional Care Services (TCS) Community Health Worker II (CHW) is responsible for promoting members’ optimal health and well-being through active engagement and helping them navigate and access health services when transitioning between care settings. The TCS CHW supports members and providers through an integrated approach inclusive of community outreach. Through assessment, collaboration, education and support, the TCS CHW helps identify and resolve members’ barriers to safe care transitions from facilities by ensuring coordination with the facility discharge staff and connecting members to their providers as well as appropriate programs and services to support their daily functioning.</p><h4>Duties</h4><p>Cultural Mediation Among Individuals, Communities, and Health and Social Service Systems: Educating individuals and communities about how to use health and social service systems (including understanding how systems operate). Educating systems about community perspectives and cultural norms. Building health literacy and cross-cultural communication. (5%)</p><p>Providing Culturally Appropriate Health Education and Information: Conducting health promotion and disease prevention education in a manner that matches linguistic and cultural needs of members. Providing necessary information to understand and prevent diseases and help members manage health conditions (including chronic disease). (5%)</p><p>Care Coordination, Case Management, and System Navigation: Participating in telephonic and/or in-person care coordination and case management with members, facility staff, and providers. Making post-transition referrals and providing follow-up. Coordinating transportation to services and helping address barriers to services. Documenting and tracking individual and population level data. Informing people and systems about community assets and challenges. (25%)</p><p>Providing Coaching and Social Support: Providing individual support and coaching, including how to manage their health conditions following discharge and identifying critical symptoms. Motivating and encouraging people to obtain care and other services. Supporting self-management of disease prevention and management of health conditions (including chronic disease). Planning and/or leading support and health education groups. (10%)</p><h4>Advocating for Individuals and Communities: Advocating for the needs and perspectives of communities. Connecting to resources and advocating for basic needs (e.g. food and housing). Conducting policy advocacy for their communities. (5%) </h4><h4>Building Individual and Community Capacity: Building individual and community capacity by training with peers and among CHW groups. (5%)</h4><h4>Implementing Individual Assessments: Participating in design, implementation, and interpretation of individual-level assessments (e.g. Health Risk Assessments, medication reviews, home environmental and safety assessment). (10%)</h4><h4>Duties Continued</h4><h4>Conducting Outreach: Telephonic and/or in-person recruitment of individuals and families to participate in Transitional Care Services and other supports. Follow up on health and social service encounters with individuals and families, in coordination with primary care providers and facility staff. Home visiting to provide education, assessment, and social support following a care transition, if appropriate. (25%)</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><h4>Experience</h4><p>Required:<br>At least 6 months of experience as a health navigator, peer support worker, outreach worker, promotora, or working in a community setting and providing health education for chronic conditions, or equivalent.</p><h4>Skills</h4><p>Required:</p><p>Knowledge of community resources for Medi-Cal members. </p><p>Comfortable working with diverse populations.</p><p>Exceptional ability to connect and engage with people.</p><p>Willingness to work in various environments including 1:1 in member’s homes, hospitals, skilled nursing facilities, other clinical settings, and/ or shelters.</p><p>Excellent verbal and written communication skills.</p><p>Detail oriented, organized and possess time management skills.</p><p>Basic computer skills.</p><p>Preferred:&nbsp;</p><p><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>Mental Health First Aide Certification<h4>Required Training</h4><p>Preferred:<br>Successful completion of a Community Health Worker formal training program from a college or other education institution is preferred.</p><p>Training in health education for chronic diseases, motivational interviewing is desirable.</p><h4>Physical Requirements</h4><h4>Additional Information</h4><p>Required:</p><p>Must have access to reliable transportation to carry out job-related essential functions.</p><p>Able to work flexible job hours.</p><p>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>                    Public Health, Travel Nurse, Medical, Counseling, Healthcare                                                    </p>

Transitional Care Services Community Health Worker II

<p>Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&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 Enhanced Care Management (ECM) Clinical Specialist II is responsible for the management and oversight activities associated with L.A. Care's ECM network.&nbsp; The position reports to the Supervisor of ECM and receives clinical supervision as needed from the Medical Director of Care Management. The position is responsible for providing oversight, feedback, and technical assistance to ECM Providers to support effective delivery of ECM services and ensure compliance with local, State, and Federal regulations, statues and guidelines. The position is responsible for conducting regular meetings with providers, reviewing Assessments &amp; Care Plans, providing guidance on clinical best practices, and assisting with escalation of cases that require additional assistance from L.A. Care. The position works directly with Care Management and Provider Network Management staff to inform Provider capacity-building and training activities related to the ECM Program operations.</p><h4>Duties</h4><p>Conduct regular monitoring and coaching with Providers to review aggregate progress and individual ECM member cases. May use telephonic, onsite, or written methods and both group and individual Provider activities to monitor performance related to Provider clinical and service requirements. Provide guidance on best practices to ECM providers.</p><p>Conduct a monthly random sample review of Assessments and Care Plans created by the ECM Provider. Identify any gaps in the Care Plan services or regulatory compliance and provide coaching and feedback to the Provider to improve.&nbsp; Identify any issues that require escalation or more frequent monitoring of the ECM Provider. Organize and perform file review process in accordance with given criteria to include collection &amp; verification of supporting documentation, recording received information in appropriate tracking systems, and communicating end results of requests in writing and/or verbally. </p><p>Provide training, education and consultation as necessary to Providers. Collaborate with other ECM staff on identifying topics and developing materials for Provider training and capacity building. </p><p>Assist ECM Providers with escalation of ECM member cases that require additional assistance from L.A. Care. </p><p>Assist ECM Providers with the coordination of member care with internal L.A. Care departments such as Care Management (CM), Utilization Management (UM), Managed Long Term Services and Support (MLTSS), Social Services, Behavioral Health, Community Health, Health Education, as well as external providers such as Participating Physician Groups (PPGs) and Primary Care Physicians (PCPs). </p><p>Actively identifies and implements efforts to improve the quality, effectiveness and efficiency of ECM.&nbsp; Assist co-workers with special projects or work volume as required. Communicates any barriers to supervisors in an efficient and effective manner. </p><h4>Perform other duties as assigned.</h4><h4>Duties Continued</h4><h4>Education Required</h4>Associate's Degree in NursingMaster's Degree in Social Work for Licensed Clinical Social Workers<h4>Education Preferred</h4>Bachelor's Degree in Nursing<h4>Experience</h4><p>Required:</p><p>Minimum 3 years of&nbsp; recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments.&nbsp; </p><p>Previous care management experience to include auditing/oversight/performance management experience.</p><h4>Skills</h4><p>Required:</p><p>Current knowledge of clinical standards of care and disease processes, and community resources.</p><p>Excellent verbal and written communicating skills; excellent interpersonal skills. </p><p>Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine the most effective member-centered interventions.</p><p>Proficiency in Microsoft Office MS Office applications. </p><p>Maintain confidentiality in compliance with all Health Insurance Portability and Accountability Act (HIPAA) requirements. </p><p>Ability to solve complex issues and identify creative solutions with external agencies.&nbsp; </p><p>Excellent project management skills.</p><p>Working knowledge of Medi-Cal and Medicare regulations.</p><p>Preferred:</p><p>"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>Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse (RN); current and unrestrited California License.<h4>Licenses/Certifications Preferred</h4>Certified Professional in Utilization Review (CPUR)Certified Case Manager (CCM)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><strong>Preferred:&nbsp;</strong><br>Certification in Certified Professional in Utilization Review (CPUR), Certified Case Manager (CCM), Utilization Management or Compliance</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>                    Social Worker, Nursing, Registered Nurse, Behavioral Health, Clinic, Service, Healthcare                                                    </p>

Enhanced Care Management Clinical Specialist 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 Supervisor of Community Based Care is responsible for monitoring Community Health Workers (CHW) daily work and activities including but not limited to ensuring proper staffing and coverage, monitoring and evaluating departmental operations to ensure optimal efficiency and effectiveness. The position also assists in triaging identified issues/problems and forming resolution within the scope of work. Escalates appropriate issues to the Community Based Care Management Manager.</p><p>The Supervisor of Community Based Care is responsible in assisting and developing a successful and cohesive unit, with high level of productivity and accuracy to achieve the department's overall performance metrics. This &nbsp;position supports and assists the Community Based Care Management Manager in identification of training needs including but not limited to assisting in development of programs, training materials, competency checklist, and orientation checklists necessary to meet education and training needs of CHWs. This position is also responsible for ensuring all functions are operating in accordance with the organization's mission, values and strategic goals, which are focused on continuous improvement; and are provided in a manner that is responsive and sensitive to the needs of L.A. Care's culturally diverse membership. &nbsp;The Supervisor manages all aspects of running an efficient &nbsp;team, including hiring, supervising, coaching, disciplining, and motivating direct-reports.</p><h4>Duties</h4><p>Supervises the day to day activities of CHWs, including but not limited to: Staffing, assignment distributions and time off requests; &nbsp;Monitoring of staff's performance including productivity and compliance with regulatory requirements; Handling all questions/issues raised by staff and knowledge to know when to escalate to the manager. &nbsp;Recommends process improvement measures to achieve department's performance measures outcomes and goals. &nbsp;Plans and directs CHW activities according to model of care, program description and policy and procedures to provide timely, quality care and services to members and Interdisciplinary Care Team.</p><p>Functions as supervisor in assigned line of business and responsible for identifying the training needs including but not limited to assisting in the development of programs, training materials, orientation checklist, and competence checklist necessary to meet educational needs. Responsible for training new staff and cross-training in specified line of business. &nbsp;Developing tools and workflows to assist in training and development of staff. Completes evaluation of staff and provides recommendation in the hiring &nbsp;and termination process of staff. Monitor staff's performance, identifies and communicates areas that needs performance management to ensure employee compliance with regulatory requirements, policies and procedures.&nbsp;</p><p>Develop and maintain positive working relationships with all business partners to ensure optimum member care and provider satisfaction. Serves as a leader and role model as well as technical and informational resource for staff and peers. Foster a culture that encourages employee contribution to ensure that the department maintains an environment in which quality flourishes and recommends resources to reach new standards.</p><p>Maintain all assigned reporting responsibilities. Conducts regular audit activity via department's performance reporting standards to maintain quality care of members and compliance to regulatory requirements. Assures the accuracy of &nbsp;reports and department proficiency in maintaining regulatory standards and time frames. Provides reports to manager to identify trends and improve work flow process.</p><p>Ensure department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations relating to protection of personal history information (PHI).</p><p>Perform other duties as assigned.</p><h4>Duties Continued</h4><h4>Education Required</h4>Associate's or Bachelor's Degree in NursingIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Social Work or Related Field<h4>Experience</h4><p><br>Required:</p><p>Minimum of 3 years of recent community based care management experience in a medical or managed care setting, such as a health insurance environment and/or in community clinic/hospital environments.</p><p>At least 3 years of leading process, program, or staff or supervisory experience.</p><p>Equivalency:&nbsp; Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.</p><h4>Skills</h4><p>Required:<br>Knowledge of state, federal and regulatory requirements in Care Management and Community Based Care.</p><p>Strong verbal and written communication skills.</p><p>Computer literacy with proficiency with Microsoft Word, Excel, etc. and core departmental system.&nbsp;</p><p>Excellent organizational, time management and interpersonal skills.</p><p>Must be detailed oriented and an enthusiastic team player.</p><p>Ability to work independently and with internal and external customers.&nbsp;</p><p>Ability to solve complex issues and identify and implement creative solutions.&nbsp;</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Care Management CertificationRegistered Nurse (RN) - Active, current and unrestricted California LicenseLicensed Clinical Social Worker (LCSW) - Active, current and unrestricted California License<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><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>                    Social Worker, Nursing, Registered Nurse, Travel Nurse, Public Health, Service, Healthcare                                                    </p>

Supervisor, Community Based Care

<p>Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&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 Technical Project Analyst (TPA) II supports projects with Project Managers and/or business partners to ensure quality and completeness of a given task or project in workplace. This position organizes, analyzes, and recommends solutions that meets regulatory and operational standards. The TPA provides small scale technical solutions to streamline operational processes. Doing what is necessary to get the job done accurately and efficiently is imperative to the organization. </p><h4>Duties</h4><p>Critical evaluation of information gathered from multiple sources, data conflict reconciliation, dissemination of high-level concepts into details, distinguishing true needs from amongst the collection of requirements, and creating logical and innovative solutions to complex problems. Clearly presenting issues and solution options. Providing statistical analysis to make data driven recommendations. </p><p>Providing complex metrics and project related reporting support to all relevant stakeholders. Prepare executive summaries, as needed. Communicate task progress to all team members. Must possess the skills to foster a professional relationship at all levels. Fulfill, analyze, and generate report requests by using available tools such as database queries, canned reports, and other data.</p><p>Proactively identifying potential issues and driving resolution to avoid customer impact and facilitate continuous improvement. Collaborate with the business partners and technical team to satisfy organizational projects and initiatives.</p><p>Gather, analyze, verify, define and document actionable Business Requirements. Create clear and meaningful business and functional requirements for business and technical partners. Analyze operations and recommend business process improvements.</p><p>Engage all relevant participants; particularly during the requirement gathering work sessions, where appropriate. Build internal tools and methodologies to streamline various processes. Willingness to share skills, knowledge, and expertise to team members</p><p>Perform other duties as assigned.</p><h4>Duties Continued</h4><h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree<h4>Experience</h4><p><strong>Required:</strong><br>A minimum of 5 years of experience as a Project Analyst or business process analyst working with computerized management systems and handling small to large projects with at least&nbsp; 5 years direct experience developing small scale technical solutions to streamline operational processes.</p><p>Must have Managed Care experience.</p><p><strong>Preferred:</strong><br>Medicaid, Medicare experience.</p><h4>Skills</h4><p>Required:<br>Thorough knowledge of Healthcare data elements required.</p><p>Thorough understanding of relevant industry practices, techniques and standards.</p><p>Proficiency with process modeling, analysis and simulation tools; Broad working knowledge of business analysis practices and procedures.</p><p>Must have a comprehensive understanding of business process/ life cycle management principles, theories and concepts.</p><p>Proficiency in Microsoft Office applications (Excel, Visio, Project, Access, and Word) and Project Management tools; Basic understanding of data models and SQL.</p><p>Strong analytical, problem solving, critical and lateral thinking skills.</p><p>Values ongoing learning and growth to become fluent with changing business processes, proprietary systems, and software.</p><p>Clear written and verbal communication skills and the ability to effectively interface with business partners and technical team.</p><p>Demonstrate the ability to structure analysis and use analysis to help identify root causes versus underlying symptoms and make solid recommendations for improvement; Ability to listen, analyze issues, distinguish true needs, and recommend solutions.&nbsp;</p><p>Proven ability to significantly impact process improvement and process management.</p><p>Ability to work independently and to think outside the box for solutions.</p><p>Demonstrate ability to work well with others, both inside of the team and across the organization.</p><p>Ability to document scope, business requirements in a clear and concise manner; Articulates relevant information and directions in an organized and concise manner.</p><p>Ability to exercise considerable individual judgment and initiative in conducting the necessary operations within a task and/or project; ability to conform to shifting priorities, demands, and timelines through analytical and problem-solving capabilities.</p><p>Ability to be accurate, with a keen attention to detail is critical.</p><p>Ability to coordinate project activities with diverse groups and individual.</p><p>Ability to comfortably work with upper management and Leadership team.</p><p>Ability to work on multiple assignments simultaneously, prioritize tasks and know when to escalate issues.</p><p>Ability to work under challenging deadlines.</p><p>Ability to determine details within a project work plan to support next steps.</p><p>Preferred:<br>Proficient with Process Improvement Methodology including defining and documenting workflow.</p><p>Program and project level planning, mobilization and management.</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                                                                            <br><strong>Job Segment: </strong>                    Claims, Medicaid, Medicare, Healthcare, Insurance                                                    </p>

Technical Project Analyst II

<p>Salary Range:&nbsp;&nbsp;$47,840.00&nbsp;(Min.) -&nbsp;$57,062.00&nbsp;(Mid.) -&nbsp;$68,474.00&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 Community Resource Center (CRC) Specialist II supports in building relationships with members of the community, L.A. Care departments, and Blue Shield of California Promise Health Plan staff (under a collaborative partnership agreement), community based agencies, government agencies, and CRC vendors and instructors. The role supports community and provider communication and engagement initiatives to increase member traffic at a CRC and provides information to members of the community to physical and health education programs, classes and resources. Acts as a key partner to support the CRC marketing and promotional initiatives to meet operational needs. Follows workflows to refer members to receive services across L.A. Care departments that support a member's health care journey to promote positive health care outcomes. Helps connect members and community participants in understanding health care access issues, identifies resource needs based on social drivers resulting from member inquiries and health assessments, and refers to the appropriate source for subject matter assistance. Provides ongoing member assistance and follow-up in select cases. Works in partnership with L.A. Care health plan departments to provide customer service, social services support, care management, health education resources, behavioral health, member engagement marketing and communication, relies on line of business product knowledge and business insight. The CRCs serve anyone in the community in which they are located; and therefore, this role will provide support on referral processes to connect non-member cases to the appropriate external resources and collaborate with key stakeholders across L.A. Care in support of positive outcomes for members.</p><p>Supports the planning and development, implementation, and analysis of CRC services, programming, and vendor management. This role may support special projects following directions and instructions from a work plan, technical procedures, and relationship management ensuring successful implementation of CRC initiatives. </p><h4>Duties</h4><p>Day-to-Day Representation: (25%)<br>Supports the coordination of member-centric customer service to respond and resolve inquiries and questions and bridges members to appropriate resources. &nbsp;Provides guidance and support to inform, guide, and educate members, community residents, and other stakeholders regarding health education programs, benefit information, resources and support available at L.A. Care and partner health plan benefits, CRC resources to meet the member/visitor needs. Collaborates with team members to create resource guides and reference materials. &nbsp;Implements the appropriate approach to identify member or visitor resource needs in complex situations and takes action to link the member/visitor to the appropriate services, programs, or resources. Actively identifies gaps in CRC services, resources, and programs, delivers recommendations for new programs and proposes solutions for the implementation of new services. &nbsp;Participates in day-to-day work operations including opening and closing of the CRC, ordering and maintaining of office supplies, and inventory. Supports CRC vendors which deliver facility maintenance. Coordinates, maintains, and schedules CRC calendar and conference rooms, including management of appointments. Prepares conference/training rooms and assists with support services, as needed. Answers incoming calls in a timely and professional manner. &nbsp;</p><p>High-Touch Customer Focus: (25%)&nbsp;<br>Performs high quality in-person service and contributes to the extended-hour schedule of the CRC to support members and visitors that may need services outside of regular operating hours and days based on business needs. Implements child development activities and programs to support children development while parents and guardians attend a class or service appointment at the CRC. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</p><p>Cross-Collaboration: (20%)<br>Supports community initiatives maintaining good relationships within L.A. Care and Blue Shield Promise Health Plan, and with community stakeholders to promote access to health care programs, classes, and preventative services offered at the CRC. &nbsp;Provides information to other L.A. Care departments on services and activities that resonate with and engage members of the CRC community based on hands-on experience at the Center.</p><p>Outreach and Engagement: (15%)</p><p>Supports and nurtures relationships with key internal and external stakeholders; and, is an ambassador to promote CRC partnership brand recognition. &nbsp;Establishes relationships with key community stakeholders, informs management on community needs, and enters data to inform an integrated approach to outreach activities and targeted member engagement. &nbsp;Supports planning, development, implementation, and analysis, of member and community engagement activities to increase member traffic at the supports outreach and engagement activities to attract new L.A. Care and partner health plan members into the CRC to participate in services and programs. Provides feedback to bridge members of the community to physical and health education programs and classes which will enhance health outcomes and member experience. &nbsp;Supports communications and marketing efforts through multiple platforms to increase member traffic at assigned CRC.</p><h4>Duties Continued</h4><p>Implementing Strategic Initiatives: (15%)<br>Supports the implementation of special projects which include identifying the scope of work responsibilities, accountabilities, deliverables, key milestones, timelines, and specific tasks that &nbsp;must be completed in order to ensure project, initiatives, and events are successfully implemented within the required timeframe.<br>Supports in monitoring risks and provides recommendations for management to implement mitigation plans to keep initiatives on-track. &nbsp;Collaborates in the maintenance of consistent documentation of project deliverables, tracks and reports project status. &nbsp;&nbsp;</p><p>Performs other duties as assigned. (10%)</p><h4>Education Required</h4>Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Bachelor's Degree<h4>Experience</h4><p>Required:<br>At least 6 months of community work focused on health care, public health, or health education, OR at least 6 months of operations work experience, community events, leading projects, and supporting relationships with multiple stakeholders.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<br>Experience with data entry and reporting processes.&nbsp;</p><p>Preferred:<br>Previous experience in child development activities. &nbsp;</p><h4>Skills</h4><p>Required:<br>Ability to communicate verbally and in writing.</p><p>Organizational skills.</p><p>Detail-oriented, collaborative and enthusiastic team player.&nbsp;</p><p>Ability to assist with inquiries and identify creative solutions to assist members and community stakeholders.</p><p>Ability to troubleshoot problem areas and support effective alternative solutions and provide optimal customer service for internal and external customers.</p><p>Action oriented attitude to take on new opportunities and rewarding challenges with a sense of urgency, high energy, and enthusiasm.</p><p>Ability to multi-task and meet competing deadlines while maintaining attention to detail and accuracy.</p><p>Ability to work independently or as part of a diverse team while applying business-insight as well as empathy towards members.</p><p>Initiative to act on anticipated business needs in the operational and customer service areas.<br><br>Ability to adapt quickly to a fast-changing environment.</p><p>Knowledge of MS Office including Outlook, Word, Excel, and PowerPoint</p><p>Excellent customer service skills.</p><p>Interpersonal skills, ability to read non-verbal cues and apply situational adaptability skills.</p><p>Ability to make sound decisions with incomplete information.</p><p>Preferred:<br>Experience with the Salesforce Customer Relationship Management (CRM) platform</p><p>Knowledge and understanding of the unique needs of the Medi-Cal beneficiary populations within a social service, healthcare, not-for-profit, or government setting.&nbsp;</p><p>Knowledge of public agencies, organizations, and other resources that support Community Resource Center visitors.</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.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><p>Required:&nbsp;<br>Cardiopulmonary&nbsp;resuscitation &nbsp;(CPR) and California Mandated Reporter within 90 days-of-hire</p><p>Preferred:&nbsp;<br>Management of Aggressive Behavior (MOAB), de-escalation techniques training, safe lifting practices training.</p><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>Required:</p><p>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>                    Relationship Manager, Public Health, Behavioral Health, Data Entry, Social Services, Customer Service, Healthcare, Administrative, Service                                                    </p>

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