L.A. Care Health Plan
Lead Product Solutions Manager
L.A. Care Health Plan, Los Angeles, California, United States, 90079
Lead Product Solutions Manager
Job Category:
Administrative, HR, Business ProfessionalsLocation:
Los Angeles, CA, US, 90017Position Type:
Full TimeRequisition ID:
11722Salary Range:
$117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.)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.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.The Lead Product Solutions Manager provides program support (end to end) for the ongoing operations of the product line annual cycle. This role is cross-functional. The Lead Product Manager must partner closely with key stakeholders including but not limited to Information Technology (I.T.), Operations, Health Services, Marketing & Sales to develop, organize, and execute the department priorities, resource commitments, and deliverables. The ideal candidate has extensive healthcare knowledge and experience (Commercial, Cal MediConnect and/or D-SNP, Medi-Cal) and will work independently to lead and facilitate complex projects, initiatives that ensure deliverables are aligned with the line of business objectives, on time, and aligned with product retention and growth objectives. Responsible for the daily workflow and leading the work of assigned staff. This role will mentor, coach, act as a resource, and provide feedback on performance of assigned staff.Duties
Provides organizational representation in policy workgroups and stakeholder meetings and summits. Evaluates policy and regulatory changes to identify impacts to product and current business processes. Develops impact assessments and execution plans for implementation of new guidance.Provides support by identifying opportunities and leading improvement projects to drive quality, membership, and revenue and enhance the member experience. Identifies, provides solutions, and executes projects to maximize enrollment and growth opportunities allowed by regulation/regulators. Manages and leads cross-functional partnerships with stakeholders responsible for improving stars and quality measures to improve effectuation and monthly payments. Reviews current program data to identify areas for cost containment initiatives (i.e. encounters, utilization, rates) and influences process improvement plans.Leads annual cycle work: identifies lessons learned, product roadmap, product/benefit design, coordinates with I.T. and other cross-functional teams to develop critical cycle pathways. Ensures excellent service delivery and experience. Builds an understandable and scalable process for continued product cycle development and improvement. Leads full annual cycle work. Supports business units on developing and executing process improvement plans, monitoring programs, and enhancements to promote efficiency, quality, and compliance. Partners with functional areas to resolve day-to-day issues impacting product performance.Responsible for leading daily operational activities including staffing, productivity, and quality of work. Participates in hiring, coaching, training, counseling, and provides feedback on staff performance. Oversees the daily office workflow, develops and recommends enhancements to process and procedures.Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.Performs other duties as assigned.Education Required
Bachelor's Degree. In lieu of degree, equivalent education and/or experience may be considered.Education Preferred
Master's Degree in Public Health or Related FieldExperience
Required:At least 6 years in managed care (Medicare, Commercial, and/or Medi-Cal). Direct experience in managed care functions including stars, quality, financial performance review, operational functions (claims, enrollment, readiness). Risk management and mitigating planning experience.At least 3 years of lead experience (process, program, or staff).Preferred:Minimum of 10 years of direct experience.Skills
Required:Knowledge of product management and strategic planning and packaging concepts.Ability to lead, manage, conclude, and recommend using data and experience-driven decisions.Ability to lead, mentor, and coach cross-functional teams through ambiguity.Ability to make decisions to drive towards and accomplish team objectives.Strategic thinking skills and ability to create messaging to influence desired outcomes.Ability to anticipate future demands of initiatives related to people, technology, budget, and business within your department and design/implement solutions to meet these needs.Able to communicate results and business impacts to stakeholders within and outside of the company.Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Preferred:Six Sigma Training, Product Management Professional TrainingPhysical Requirements
LightAdditional Information
Department SpecificCommercial Product:
Required:5+ Commercial annual rate setting experience5+ Commercial risk adjustment experience8+ year of leading large-scale cross-functional initiativesExperience with Department of Managed Health Care (DMHC) & Covered CA contractual requirementsCal MediConnect (CMC)/ D-SNP:
Required:Centers for Medicare and Medicaid Services (CMS) annual rate setting experienceCMS risk adjustment experience8+ year of leading large-scale cross-functional initiativesExperience CMS guidelines & regulatory policyMedicare Advantage, D-SNP and CMC quality & star ratingAbility to access, review and interpret CMS communications including memos, guidance, Advanced call letter and Final Call letter for impacts to Medicare product management.Medi-Cal Product:
Required:5 years of Medi-Cal managed care experienceExperience serving Medi-Cal populationUnderstanding of Medi-Cal regulatory and program requirementsSalary Range Disclaimer:
The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.L.A. Care offers a wide range of benefits including:Paid Time Off (PTO)Tuition ReimbursementRetirement PlansMedical, Dental and VisionWellness ProgramNearest Major Market:
Los AngelesJob Segment:
Medicare, Medicaid, Public Health, Claims, Risk Management, Healthcare, Insurance, Finance
#J-18808-Ljbffr
Job Category:
Administrative, HR, Business ProfessionalsLocation:
Los Angeles, CA, US, 90017Position Type:
Full TimeRequisition ID:
11722Salary Range:
$117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.)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.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.The Lead Product Solutions Manager provides program support (end to end) for the ongoing operations of the product line annual cycle. This role is cross-functional. The Lead Product Manager must partner closely with key stakeholders including but not limited to Information Technology (I.T.), Operations, Health Services, Marketing & Sales to develop, organize, and execute the department priorities, resource commitments, and deliverables. The ideal candidate has extensive healthcare knowledge and experience (Commercial, Cal MediConnect and/or D-SNP, Medi-Cal) and will work independently to lead and facilitate complex projects, initiatives that ensure deliverables are aligned with the line of business objectives, on time, and aligned with product retention and growth objectives. Responsible for the daily workflow and leading the work of assigned staff. This role will mentor, coach, act as a resource, and provide feedback on performance of assigned staff.Duties
Provides organizational representation in policy workgroups and stakeholder meetings and summits. Evaluates policy and regulatory changes to identify impacts to product and current business processes. Develops impact assessments and execution plans for implementation of new guidance.Provides support by identifying opportunities and leading improvement projects to drive quality, membership, and revenue and enhance the member experience. Identifies, provides solutions, and executes projects to maximize enrollment and growth opportunities allowed by regulation/regulators. Manages and leads cross-functional partnerships with stakeholders responsible for improving stars and quality measures to improve effectuation and monthly payments. Reviews current program data to identify areas for cost containment initiatives (i.e. encounters, utilization, rates) and influences process improvement plans.Leads annual cycle work: identifies lessons learned, product roadmap, product/benefit design, coordinates with I.T. and other cross-functional teams to develop critical cycle pathways. Ensures excellent service delivery and experience. Builds an understandable and scalable process for continued product cycle development and improvement. Leads full annual cycle work. Supports business units on developing and executing process improvement plans, monitoring programs, and enhancements to promote efficiency, quality, and compliance. Partners with functional areas to resolve day-to-day issues impacting product performance.Responsible for leading daily operational activities including staffing, productivity, and quality of work. Participates in hiring, coaching, training, counseling, and provides feedback on staff performance. Oversees the daily office workflow, develops and recommends enhancements to process and procedures.Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.Performs other duties as assigned.Education Required
Bachelor's Degree. In lieu of degree, equivalent education and/or experience may be considered.Education Preferred
Master's Degree in Public Health or Related FieldExperience
Required:At least 6 years in managed care (Medicare, Commercial, and/or Medi-Cal). Direct experience in managed care functions including stars, quality, financial performance review, operational functions (claims, enrollment, readiness). Risk management and mitigating planning experience.At least 3 years of lead experience (process, program, or staff).Preferred:Minimum of 10 years of direct experience.Skills
Required:Knowledge of product management and strategic planning and packaging concepts.Ability to lead, manage, conclude, and recommend using data and experience-driven decisions.Ability to lead, mentor, and coach cross-functional teams through ambiguity.Ability to make decisions to drive towards and accomplish team objectives.Strategic thinking skills and ability to create messaging to influence desired outcomes.Ability to anticipate future demands of initiatives related to people, technology, budget, and business within your department and design/implement solutions to meet these needs.Able to communicate results and business impacts to stakeholders within and outside of the company.Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Preferred:Six Sigma Training, Product Management Professional TrainingPhysical Requirements
LightAdditional Information
Department SpecificCommercial Product:
Required:5+ Commercial annual rate setting experience5+ Commercial risk adjustment experience8+ year of leading large-scale cross-functional initiativesExperience with Department of Managed Health Care (DMHC) & Covered CA contractual requirementsCal MediConnect (CMC)/ D-SNP:
Required:Centers for Medicare and Medicaid Services (CMS) annual rate setting experienceCMS risk adjustment experience8+ year of leading large-scale cross-functional initiativesExperience CMS guidelines & regulatory policyMedicare Advantage, D-SNP and CMC quality & star ratingAbility to access, review and interpret CMS communications including memos, guidance, Advanced call letter and Final Call letter for impacts to Medicare product management.Medi-Cal Product:
Required:5 years of Medi-Cal managed care experienceExperience serving Medi-Cal populationUnderstanding of Medi-Cal regulatory and program requirementsSalary Range Disclaimer:
The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.L.A. Care offers a wide range of benefits including:Paid Time Off (PTO)Tuition ReimbursementRetirement PlansMedical, Dental and VisionWellness ProgramNearest Major Market:
Los AngelesJob Segment:
Medicare, Medicaid, Public Health, Claims, Risk Management, Healthcare, Insurance, Finance
#J-18808-Ljbffr