CareAdvantage Program Manager

CareAdvantage Program Manager I

Responsible for program development, integration, and execution in support of departmental processes, operations, and administrative efficiency for the CareAdvantage department. Responsible for engaging with internal and external stakeholders to develop, manage, and improve programs related to HPSM’s CareAdvantage members. The Program Manager provides operational support and relationship management for ongoing contracted provider and vendor delivered programs, with a focus on quality, accessibility, sustainability, and integration within HPSM.

Essential Functions:

• Manage program(s) from initiation through delivery and monitor for continuous improvement.
• Support and contribute to core Dual Eligible Special Needs Plan (D-SNP) processes, including Medicare Star Ratings, Risk Adjustment, and the Medicare Advantage Prescription Drug Plan (MA-PD) Bid Process.
• Develop methods, techniques, and evaluation criterion for obtaining improved outcomes and prioritized goals of the CareAdvantage program.
• Contribute to the design of strategies that align CareAdvantage program goals with departmental goals and objectives.
• Plan, execute and evaluate program initiatives to improve performance on program goals, as well as aligned departmental or organizational goals.
• Participate cross-functionally in business planning to support HPSM initiatives with a focus on member/population care and compliance with Federal and State standards and regulations.
• Serve as primary point person and relationship liaison to applicable external partners and vendors who support HPSM’s CareAdvantage program and outcomes; educate and work with external partners as needed to identify innovation opportunities and improve processes and outcomes.
• Contribute to project teams, which may include assigning and monitoring work of team members, providing expert input, or providing general guidance and leadership in teams without direct reporting authority.
• May act as the business unit liaison to corporate initiatives and projects.
• Design and maintain robust key performance indicator dashboards to reflect impact of programs.
• Appropriately escalate concerns to supervisor while holding stakeholders accountable.
• Engage in critical thinking and creative problem solving, appropriately pivoting program priorities to meet business needs.

Secondary Functions:

• Perform other duties as assigned.

Requirements

These are the qualifications typically needed to succeed in this position. However, you don’t need to meet every requirement to apply. 

Education and experience

• Bachelor’s Degree in Business Administration, Public Health, Health Care Management, or Public Policy required. MBA, MPH or MPP preferred.
• Minimum one (1) year of managed care experience preferably with Medicare/Medi-Cal experience
• Minimum three (3) years of project/program management experience.
• Experience with quality improvement/process improvement techniques.

Knowledge of:

• Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access, and PowerPoint.
• Relationship Building and Interpersonal Skills
• Financial/Quantitative Acumen
• Change management, process improvement and redesign.
• Organizational behavior skills with a focus on driving for results
• Project management, program evaluation and consulting skills.
• Knowledge of accrediting/regulatory body requirements

Ability to:

• Work cooperatively with others.
• Work as part of a team and support team decisions.
• Communicate effectively, both verbally and in writing.
• Adapt to changes in requirements/priorities for daily and specialized tasks.
• Think critically and make informed decisions.

Salary and benefits

The starting salary range is $92,240 - $118,484 annually, depending on the candidate’s work experience.

Excellent benefits package includes:

• HPSM-paid premiums for employee’s medical, dental and vision coverage (employee pays 10% of each dependent’s premiums)
• Fully paid life, AD&D and LTD insurance
• Retirement plan (HPSM contributes equivalent of 10% of annual compensation)
• 12 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year
• Tuition reimbursement plan
• Employee wellness program

It is HPSM's policy to provide equal employment opportunity for all applicants and employees.  HPSM does not unlawfully discriminate based on race, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation, veteran status, registered domestic partner status, genetic information, gender, gender identity, gender expression, or any other characteristic protected by applicable federal, state, or local law.  HPSM also prohibits discrimination based on the perception that an applicant or employee has any of those characteristics or is associated with a person who has or is perceived to have any of those characteristics.