Chief Operating Officer (COO)

CalOptima; Orange (CA); On-site; USD 433,000 - 714,000; Full time

Benefits offered by this job

PTO program

Quality work life balance

Wellness programs

Tuition reimbursement

Professional development opportunities

Career development opportunities

Flexible scheduling

Job summary

CalOptima Health is seeking a Chief Operating Officer to join the Executive Office and drive health plan operations, governance, and provider networks in California. You will lead cross-functional teams, improve processes, and ensure regulatory and strategic alignment to advance member health with dignity.

The role requires a Bachelor’s degree and 8+ years in managed-care operations at an executive level, with government program experience and strong procurement/contract leadership.

Qualifications

• Bachelor's degree PLUS 8 years of experience in managed-care operations at an executive level required.
• Experience in government programs required.
• Experience in leading procurement, requests for proposals and contracts in a public agency environment required.
• Have access to means of transportation for work away from the primary office approximately 10% of the time.

Responsibilities

• Provide strategic leadership and operational management for CalOptima Health.
• Oversee Claims, Customer Service, Grievances & Appeals, Coding Initiatives, Provider Contracting, Provider Relations, Provider Data Management Services, and Information Security.
• Direct and manage cross-organizational collaboration for agency-wide projects and initiatives.
• Develop and manage the department's annual budget and ensure adherence to it.
• Lead succession planning and develop leaders to ensure organizational continuity.
• Engage with providers, members, employees, auditors and regulators.

Job description

The Team You'll Join

We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person.

Help us build healthier communities for all.

More About the Opportunity

We are hoping you will join us as a Chief Operating Officer (COO) and help shape the future of healthcare where you'll be an integral part of our Executive Office team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Full Office.

The Chief Operating Officer (COO) will serve as a member of the executive team and contribute to strategic planning for the organization. You will be a key leader within the health plan and have the authority and accountability to lead the areas assigned to next-level capabilities and operational efficiencies consistent with the strategic plan, goals, and objectives for CalOptima Health. In this role, you will anticipate needs, continuously improve processes, communicate effectively and leverage resources while balancing and achieving set accountabilities within the constraints of limited resources. Additionally, you will be directly responsible for health plan operations, the provider network, information security, and the Executive Directors who oversee these areas. Together, we are building a stronger, more equitable health system.

Your Contributions To the Team:

• 90% - Strategic Leadership & Operational Management
• 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.
• Provides high-level oversight of Claims, Customer Service, Grievances & Appeals, Coding Initiatives, Provider Contracting, Provider Relations, Provider Data Management Services, and Information Security departments.
• Manages cross-organizational collaboration for agency-wide projects and initiatives, ensuring effective operations and consistent delivery of results and metrics.
• Provides updates and presentations to CalOptima Health's Board of Directors.
• Deploys strategies, develops workflows, and maintains ongoing operational compliance and reporting to satisfy and exceed state and federal standards.
• Identifies, develops and implements best practices.
• Develops, administers and ensures adherence to the department's annual budget.
• Hires and retains capable staff to build a successful talent base that executes strategy and operations plans.
• Leads succession planning and develops leaders to ensure organizational continuity.
• Engages regularly with providers, members, employees, auditors and regulators.
• 10% - Other
• Completes other projects and duties as assigned.

Do You Have What the Role Requires?

• Bachelor's degree PLUS 8 years of experience in managed-care operations at an executive level 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.
• Experience in government programs required.
• Experience in leading procurement, requests for proposals and contracts in a public agency environment required.
• Have access to means of transportation for work away from the primary office approximately 10% of the time.

You’ll Stand Out More If You Possess the Following:

• Master's degree in health administration, public health, business administration or similar field.
• Experience as a COO or a position of similar responsibility.
• Experience presenting to a board of directors, public committees or legislative bodies.

What the Regulatory Agencies Need You to Possess?

n/a

Your Knowledge & Abilities to Bring to this Role:

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• 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.

Your Physical Requirements (With or Without Accommodations):

• 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.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment less than 10 pounds

Ways We Are Here For You

• You’ll enjoy competitive compensation for this role.
• Our current hiring range is: Pay Grade: 329 - $433,000 - $713,900 ($208.17 - $343.2212).
• 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.
• This position is approved for Full Office (**If the position is Telework, it is eligible in California only**)
• https://www.caloptima.org/en/careers#benefits
• CalPERS pension program and additional retirement packages.

Additional benefits and perks including:

• 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.

Our Work Environment:

• If located at the 500, 505 Building or a remote work location:
  • Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
  • There are no harmful environmental conditions present for this job.
  • The noise level in this work environment is usually moderate.
• If located at PACE:
  • Work is typically indoors in a clinical setting serving the frail and elderly.
  • There may be harmful or hazardous environmental conditions present for this job.
  • The noise level in this work environment is usually moderate to loud.
• If located in the Community:
  • Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
  • Employee will occasionally work outdoors in varied temperatures.
  • There may be harmful or hazardous environmental conditions present for this job.
  • The noise level in this work environment is usually moderate to loud.

Why Join Us?

We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare.

CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit.

CalOptima Health wants to have qualified employees in every job position.

CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws.

CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at [phone] if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.