L.A. Care Health Plan · 17 hours ago
Product Solutions Manager III
Los Angeles, CA
Full-time
Onsite
Senior Level
$102K/yr - $163K/yr
5+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, created to provide health coverage to low-income Los Angeles County residents. The Product Solutions Manager III is responsible for supporting product leadership by managing product lines, navigating regulatory environments, and driving performance to align with strategic goals.
FitnessGovernmentHealth Care
Responsibilities
Supports the assigned product lines in policy and regulatory efforts. Evaluates policy and regulatory changes to identify impacts to current processes and supports implementation initiatives
Assess market strategy white papers, Legal memos, legislation/mandate language, regulatory changes and/or regulator model contracts and provides an impact recommendations, feasibility and execution plan
Responsible for defining product strategy and positioning. Drive design, feasibility and definition of new innovations and manages the ongoing evolution, growth, and strategic direction of assigned PSSM unit and its portfolio
Conducts cost/benefit analyses, needs assessment and data analysis in order to align strategy, design and business solutions with business objectives. Leads and documents requirement sessions/JAD sessions
Manage cross-functional partnerships with stakeholders responsible for quality measures and policy initiatives. Reviews data to monitor product performance and identify areas for cost containment initiatives (i.e. encounters, utilization, rates) and develops improvement plans
Develop and design processes and product requirements that support business needs. Design methods for integrating function and process including improvement opportunities and development performance improvement plans with business units. Support business units on developing and executing process improvement plans, monitoring programs and enhancements to promote efficiency, quality, and compliance. Partner with functional areas to involve day-to-day issues impacting product performance
Orchestrate, plan and execute end to end cycle strategy, including complex development and implementation efforts for the assigned line of business and their products (on / off exchange)
Identify gaps in operational processes that impact quality scores, enrollment, revenue and member retention. Design appropriate mitigation and contingency plans. Lead efforts to identify best practices to drive product integrity and efficiency. Validate functional area readiness for effective administration of benefits and transactions for the upcoming plan year, including creation, scope and execution for enhancements and/or product cycle implementations
As a Subject Matter Expert, develop and conduct training on unit processes, for lower-tiered positions
Perform other duties as assigned
Qualification
Required
Bachelor's Degree in Public Administration or Related Field
At least 5 years of relevant experience in product development/management
Risk management and mitigating planning experience
Must have experience and knowledge with regulatory guidelines governing product lines; leads regulatory filing process for new/custom product initiatives
Experience and knowledge in Cal MediConnect (CMC) / D-SNP policy and product lines of business
Experience in improving Stars and Quality Measures
Experience in Medicare Advantage, with experience serving duals population
Direct experience in Medicare and Duals program administration including stars, quality, financial performance review, operational functions (claims, enrollment, readiness)
Experience serving Medi-Cal population
Experience working in Commercial and Group Product Health Plans
Preferred
Master's Degree in Public Administration or Related Field
Understanding of Medi-Cal managed care model, eligibility requirements, benefits, enrollment processes, and regulatory requirements governing Medi-Cal managed care plans
Understanding of managed care principles and operations
Benefits
Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)
Company
L.A. Care Health Plan
L.A. Care’s mission is to provide access to quality health care for L.A.
1001-5000 employees
H1B Sponsorship
L.A. Care Health Plan 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
2024 (1)
2023 (1)
2021 (3)
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Melanie Rainer
Chief Strategy and Transformation Officer
Recent News
2026-01-17
MarketScreener
2025-08-27
Company data provided by crunchbase