Program Manager Sr, Covered California

The Team You'll Join

We are a mission-driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person.

About the role

We are seeking a Senior Program Manager for Covered California to help shape the future of healthcare. You will be an integral part of our Strategic Development team, collaborating with providers, community partners, and local stakeholders to serve member health with dignity and respect. This position is approved for partial telework, requiring work within the State of California and in-office attendance in Orange, CA at least two days per week.

The Senior Program Manager plays a vital role in program design, development, implementation, and support of new product lines, including commercial. You will coordinate, implement, and execute tasks supporting new program development, assist in day-to-day activities, and manage cross-functional projects. This role involves interaction with CalOptima Health's executives, department management, legal counsel, and staff, as well as supporting related projects across the organization.

Responsibilities

• Program Support (85%)
  • Participate in a mission-driven culture focused on high-quality performance, customer service, consistency, dignity, and accountability.
  • Provide program leadership, recommendations, guidance, risk management, and end-to-end operational support.
  • Ensure strategic alignment of projects/programs with department goals and CalOptima Health’s strategic priorities.
  • Improve processes, systems, or products to enhance performance.
  • Plan and implement complex projects/programs spanning multiple business areas.
  • Monitor, analyze, and report on healthcare marketplace conditions, requirements, and policy developments.
  • Conduct analysis and assess information from various sources on healthcare initiatives, new programs, or assigned focus areas.
  • Partner with CalOptima Health and subject matter experts to review data, evaluate initiatives, develop reports, and make recommendations for leadership.
  • Track and manage concurrent initiatives to ensure success parameters and targets are met.
  • Develop workplans for assigned projects, managing scope, schedule, budget, and quality.
  • Create workflows, KPI dashboards, procedures, and policies, recommending changes for efficiency.
  • Develop specifications and scopes of work for RFPs, RFQs, or RFIs to support new program development.
  • Draft presentations, board reports, and memos for senior management.
  • Create detailed reports for internal departments, external stakeholders, and state agencies.
  • Support project workgroup activities.
• Administrative Support (10%)
  • Mentor staff on standards, organizational understanding, and relationship-building to promote project success.
  • Assist the team in carrying out department responsibilities and collaborating on short- and long-term goals.
  • Support vendor and purchasing activities for strategic programs and pilots.
  • Assist with day-to-day Covered California team administrative activities.
• Other Duties (5%)
  • Complete additional projects and duties as assigned.

Requirements

• Bachelor’s degree in public health, business, healthcare administration, or a related field plus 4 years of experience in healthcare programs, including cross-collaboration, coordination, and stakeholder engagement (e.g., members, providers, community partners, vendors). An equivalent combination of education and experience may be qualifying.
• Experience at a health plan, health system, provider, public agency, or hospital setting.

Preferred Qualifications

• Master’s degree.
• Experience in project/program management.
• Managed care operations experience.
• 2 years of experience in a highly matrixed, mission-driven organization.

Skills

• Develop rapport and maintain effective working relationships with leadership, staff, and external contacts of diverse backgrounds.
• Work independently with sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule, including evenings and weekends as needed.
• Organize, analyze, problem-solve, and manage projects effectively.
• Work efficiently in a fast-paced environment and manage multiple projects.
• Identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Proficiency in Microsoft Office (Word, Outlook, Excel, PowerPoint) and job-specific applications/systems.

Physical Requirements

• Ability to visually read information from computer screens, forms, and printed materials.
• Clear speech for verbal communication via telephone and in-person interactions.
• Hearing ability for verbal communication.
• Manual dexterity for typing, writing, standing, reaching, flexibility, and body movement (bending, crouching, walking, kneeling, prolonged sitting).
• Ability to lift and move objects, patients, or equipment weighing 10 to 25 pounds.

Pay

Pay Grade: 313 – $90,820 - $145,312 annually ($43.66 - $69.86/hour). The final salary offered will be based on education, job-related knowledge, experience, skills, and internal equity.

Schedule

This position is approved for partial telework, requiring work within the State of California and in-office attendance in Orange, CA at least two days per week.

Benefits

• Comprehensive benefits package.
• CalPERS pension program and additional retirement packages.
• Generous PTO program.
• Work-life balance initiatives.
• Wellness programs.
• Tuition reimbursement.
• Professional and career development opportunities.
• Flexible scheduling.