Sr Manager Strategic Development - Covered California (Sr. Manager II)

About the role

We are seeking a Sr Manager Strategic Development - Covered California (Sr. Manager II) to join our mission-driven team. This role is responsible for supporting the implementation and ongoing management of CalOptima Health's new commercial product line. Key responsibilities include managing the annual product planning cycle, collaborating with cross-functional teams, and ensuring regulatory compliance.

Responsibilities

• Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity, and accountability.
• Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department.
• Hires, manages, trains, reviews and sets goals for the team and staff.
• Maintains comprehensive documentation, timelines, and project plans to support annual benefit package requirements and product strategy milestones.
• Manages cross-functional workgroups responsible for implementing plan design updates, ensuring accurate translation into systems, materials, and member communications.
• Reviews and approves benefit language for regulatory filings, evidence of coverage (EOC), summary of benefits and coverage (SBC), and other product documents.
• Maintains ongoing relationships and mutually beneficial partnerships with CalOptima Health departments and external organizations.
• Identifies opportunities for program efficiencies, develops new processes to support successful implementation and ensures sound organizational approaches across new lines of business.
• Serves as a key leader on the product team and partners cross-functionally across CalOptima Health to ensure successful implementation of the Covered California program.
• Monitors performance of the Covered California product, including enrollment trends, member experience, utilization patterns, and key quality measures.
• Collaborates with the Office of Compliance department on annual and ongoing audits.

Requirements

• Bachelor's degree in a related field PLUS 5 years of experience in managed care plan or other health care related field with at least 2 years of prior experience that must have been in government programs at a managed care plan, including Medicaid/Medi-Cal, Medicare, or Marketplace/Commercial plans required.
• 3 years of management level experience required.

Qualifications

• Experience interfacing with local, state or federal regulators.
• Experience with value-based payment programs and risk adjustment for commercial products.

Skills

• Develops and maintains comprehensive documentation, timelines, and project plans to support annual benefit package requirements and product strategy milestones.
• Establishes, monitors, and ensures the successful execution of regulatory filings and ongoing program submissions and maintenance.
• Communicates clearly and concisely, both orally and in writing.
• Works independently and exercises sound judgment.
• Manages multiple projects and identifies opportunities for internal and external collaboration.
• Motivates and leads multi-program teams and external committees/coalitions.
• Utilizes computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Benefits

A comprehensive benefits package including CalPERS pension program and additional retirement packages. Additional benefits and perks include:

• A generous PTO program
• A quality work-life balance
• Variety of wellness programs
• Tuition reimbursement
• Professional development opportunities
• Career development opportunities
• Flexible scheduling

Pay

The current pay grade range for this role is: Pay Grade: 317 - $132,969 - $212,751 ($63.93 - $102.2841). The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors.

Schedule

This position is approved for Partial Telework. If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.

Physical Requirements

Ability to visually read information from computer screens, forms and other printed materials and information.

Ability to speak (enunciate) clearly in conversation and general communication.

Ability to work independently and exercise sound judgment.

Ability to communicate clearly and concisely, both orally and in writing.

Ability to work a flexible schedule; available to participate in evening and weekend events.

Ability to organize, be analytical, problem-solve and possess project management skills.

Ability to manage multiple projects and identify opportunities for internal and external collaboration.

Ability to motivate and lead multi-program teams and external committees/coalitions.

Ability to utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.