California Primary Care Association

Serve as internal subject matter expert on managed care health plan policies and contracts, clinic networks, strategies to improve managed care performance, value-based care models, and quality measures in order to develop and/or manage the development of educational resources, training opportunities, and technical assistance (including webinars, in-person workshops and conference events, toolkits and manuals, newsletter articles and/or brochures, web-content, etc.). Knowledge of managed care contracting and policies, provider networks, strategies to improve managed care performance, value-based care models, and quality measures.. Knowledge and experience with state and federal laws and regulations pertinent to managed care, particularly those promulgated by the Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), Department of Health Care Access and Information (HCAI), Covered California, and the Centers for Medicare & Medicaid Services (CMS).. Experience with community health centers, member-driven associations, or non-profit organizations is also preferred.. Employees also have access to an employer sponsored EAP, and various voluntary insurance plans, one that includes pet insurance.

director of managed care

Job Description Job Description Association’s Mission: California Primary Care Association's mission is to lead and position community clinics, health centers, and networks through advocacy, education, and services as key players in the health care delivery system to improve the health status of their communities. Purpose of Position: To support the development, management, and implementation of programs and projects that enhance the capabilities of community health centers and consortia in their local health care delivery system, including through value-based payment models and health plan contracts. To provide an advanced level of skilled duties including project management, training and technical assistance, education, and advocacy. Primary Responsibilities:
Serve as internal subject matter expert on managed care health plan policies and contracts, clinic networks, strategies to improve managed care performance, value-based care models, and quality measures in order to develop and/or manage the development of educational resources, training opportunities, and technical assistance (including webinars, in-person workshops and conference events, toolkits and manuals, newsletter articles and/or brochures, web-content, etc.) to support health center operations.
Team with appropriate internal staff to evaluate and respond to state and national legislation and regulations. Work with internal teams and external stakeholders to raise awareness, respond to policy proposals, and advocate for health center interests.
Build relationships with managed care plans and other stakeholder partners. Represent the Association in stakeholder advisory committees.
Conduct research, collect and analyze data, prepare reports to support advocacy efforts, educational resources and training and technical assistance, and grant deliverables.
Coordinate topic specific Peer Networks, Workgroups, and/or Task Forces that includes scheduling, supporting, leading, facilitating, communicating with members, and preparing content and presentations for meetings. Ensure alignment of the content with CPCA’s strategic plan, training and technical assistance, and regulatory/legislative agenda. Attend and possibly present as needed at other peer network, task force, workgroup, or committee meetings.
In coordination with grant/development staff, responsible for researching, preparing, submitting, and managing grant proposals and contracts; and managing existing grant-funded projects that support Association goals and meet funder guidelines and criteria.
Supervise, train, and evaluate staff when applicable.
Support the department’s vision and activities by serving as a steward to both internal and external audiences. Skills and Abilities Required:
Knowledge of managed care contracting and policies, provider networks, strategies to improve managed care performance, value-based care models, and quality measures.
Knowledge and experience with state and federal laws and regulations pertinent to managed care, particularly those promulgated by the Department of Managed Health Care (DMHC), Department of Health Care Services (DHCS), Department of Health Care Access and Information (HCAI), Covered California, and the Centers for Medicare & Medicaid Services (CMS).
Advanced problem solving, critical thinking, time management, and organization skills, paying high attention to detail.
Strong presentation and written communication skills.
Effective interpersonal and professional skills when engaging with internal staff, Association membership and Board of Directors, vendors, and partners.
Work collaboratively with senior leadership and multi departmental teams.
Proficiency in Microsoft Office and web-based applications and platforms. Additional Responsibilities:
Support the Association’s Strategic Plan.
Support the Association’s vision of being an antiracist organization.
Attend and participate in required Association meetings and events.
Participate and represent the Association as requested at state, regional, and national events.
Travel for state, regional, and national meetings, training, and site visits by air and ground transportation.
Report regularly to supervisor.
Other duties as assigned. Education and Experience: Bachelor’s degree in business administration, public health, healthcare administration, or related field required. Master’s degree preferred. Minimum of five years experience within the healthcare field, specifically in managed care. Experience with community health centers, member-driven associations, or non-profit organizations is also preferred. Relevant experience may be considered in lieu of degree requirement. Association Expectation: Due to network security this position requires the employee to have a cell phone with a data plan and home internet service, both are reimbursed at a set rate each month. All hires are required to maintain residence in California. Compensation: $92,701 - $98,154 Total Rewards : CPCA offers a comprehensive total rewards package that includes hybrid work schedule, employer paid medical, dental, vision, life, and AD&D insurance for employees. A retirement savings plan with an employer contribution of 5%. A time off package that includes vacation, sick, float-time, and a generous holiday schedule. Employees also have access to an employer sponsored EAP, and various voluntary insurance plans, one that includes pet insurance. ** To Apply: Important – As part of your cover letter please include a paragraph on the following CPCA is an antiracist organization, and as such, recognizes the importance of creating safe space to consider how privilege impacts our work. Can you identify for us how privilege has impacted your professional journey? Diversity & Inclusion: CPCA’s diverse workforce strives to represent California’s diverse population including capabilities, culture, language, experience, and socio-economic background, while also meeting the highest standards and qualifications of our industry. Powered by JazzHR
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