NEOGOV · 11 hours ago
Sr Manager, Covered California (Sr. Manager II)
Orange, CA
Full-time
Hybrid
Senior Level
$133K/yr - $213K/yr
5+ years expCalOptima is a mission-driven community-based organization that serves member health with excellence and dignity. The Sr Manager for Covered California will lead the development and implementation of medical and behavioral health clinical operations and programs, ensuring compliance and effective execution while collaborating with various stakeholders.
GovTechHuman ResourcesInformation TechnologySoftware
Responsibilities
Oversees the implementation of new programs and priorities within medical management and clinical operations to achieve gained efficiencies and focus on improvements and support of direct member care
Tracks marketplace requirements, regulatory changes that impact the program, and engagements with program staff and leadership to ensure ongoing compliance and engagement
Collaborates with business owners, IT, clinical project management, and consultants to define implementation requirements
Supports cross-functional departments in interpreting Covered California and Department of Managed Health Care (DMHC) requirements and problem-solving issues related to the line of business, including member and provider issues
Partners with Enterprise Program Management Office (EPMO) project managers and leaders to ensure program implementation and workstreams remain on track and align to the scope of the implementation project
Monitors program related processes for regulatory compliance, including but not limited to ensuring adherence to policies and procedures, oversight of delegated programs, and supporting audit activities
Oversees program reporting in coordination with business owners and IT
Supports audit readiness and compliance through ongoing collaboration with the Office of Compliance
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 department and staff
Manages and coaches teams through activities such as building strong relationships, documenting initiatives and discussions, identifying gaps/issues/solutions, standardizing tools/templates, implementing quality departmental initiatives and reporting to stakeholders and management team
Manages and coordinates the day-to-day assignment of resources and shifts in work and priorities based on departmental needs
Develops, establishes and updates department processes to maintain operational excellence
Fosters ongoing relationships and mutually beneficial partnerships with internal CalOptima Health departments and external organizations
Manages team communications to ensure consistent operations and enterprise-wide visibility
Leads implementation of new clinical and medical management programs to improve efficiency and member care
Identifies and implements process improvements to support successful program launches and organizational alignment
Collaborates with leadership to align staffing strategies and performance metrics with industry benchmarks
Builds and maintains partnerships with internal departments, delegated entities, and external organizations
Ensures program compliance with regulatory and contractual requirements through collaboration with clinical leaders
Completes other projects and duties as assigned
Qualification
Required
Bachelor's degree in health administration, public health or 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 Covered California required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying
3 years of experience in a management/leadership role required
Preferred
Master's degree in social work, psychology or related field
Experience interfacing with local, state or federal regulators
Behavioral Health clinical operations knowledge and experience
Benefits
CalPERS pension program and additional retirement packages.
A generous PTO program
A quality work life balance
Various wellness programs
Tuition Reimbursement
Professional development opportunities
Career development opportunities
Flexible scheduling
And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.
Company
NEOGOV
NEOGOV is the leading provider of workforce management software uniquely designed for the public sector, education, and public safety.
501-1000 employees
H1B Sponsorship
NEOGOV has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (11)
2024 (10)
2023 (10)
2022 (18)
2021 (14)
2020 (16)
Funding
Current Stage
Late StageTotal Funding
$700MKey Investors
Warburg Pincus
2025-07-28Secondary Market· $700M
2025-07-28Acquired
2021-06-02Private Equity
Leadership Team
Shane Evangelist
CEO
Brandon McDonald
Head Of Marketing
Recent News
Canada NewsWire
2025-11-14
2025-11-14
Government Technology US
2025-10-31
Company data provided by crunchbase