The Senior Director, Population Health reports to the Vice President, Population Health & CalAIM. This classification is characterized by the responsibility to work collaboratively with senior ...
The Senior Director, Population Health reports to the Vice President, Population Health & CalAIM. This classification is characterized by the responsibility to work collaboratively with senior ...
Senior Director, Population Health
Rancho Cucamonga, CA · On-site
$220.04K - $302.54K/yr
The Senior Director, Population Health reports to the Vice President, Population Health & CalAIM. This classification is characterized by the responsibility to work collaboratively with senior ...
Senior Director, Population Health
Rancho Cucamonga, CA · On-site
$220.04K - $302.54K/yr
The Senior Director, Population Health reports to the Vice President, Population Health & CalAIM. This classification is characterized by the responsibility to work collaboratively with senior ...
CalAIM is an initiative of the Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Medi-Cal recipients by implementing delivery system, program, and ...
New
CalAIM is an initiative of the Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Medi-Cal recipients by implementing delivery system, program, and ...
New
The Senior Director, Population Health reports to the Vice President, Population Health & CalAIM. This classification is characterized by the responsibility to work collaboratively with senior ...
The Senior Director, Population Health reports to the Vice President, Population Health & CalAIM. This classification is characterized by the responsibility to work collaboratively with senior ...
Director of Healthcare Programs
Santa Ana, CA · On-site
$140K - $155K/yr
Partner closely with all CalAIM-related programs to ensure alignment, integration, and optimal performance across services. Operational Partnership * Collaborate closely with the Operations team to ...
Director of Healthcare Programs
Santa Ana, CA · On-site
$140K - $155K/yr
Partner closely with all CalAIM-related programs to ensure alignment, integration, and optimal performance across services. Operational Partnership * Collaborate closely with the Operations team to ...
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Quick apply
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Outside Sales Account Manager
Tustin, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Quick apply
Outside Sales Account Manager
Tustin, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Outside Sales Account Manager
Anaheim, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Quick apply
Outside Sales Account Manager
Anaheim, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Outside Sales Account Manager
Anaheim, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Outside Sales Account Manager
Anaheim, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Outside Sales Account Manager
Anaheim, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Quick apply
Outside Sales Account Manager
Anaheim, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Outside Sales Account Manager
Anaheim, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Outside Sales Account Manager
Anaheim, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Quick apply
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Outside Sales Account Manager
Irvine, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Quick apply
Outside Sales Account Manager
Irvine, CA · On-site
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Prospect referral source accounts for CalAIM service line through in-field and virtual sales activities * Schedule weekly meetings with new target contacts to educate them on available services
Calaim information
What are the key skills and qualifications needed to thrive as a California Advancing and Innovating Medi-Cal (CalAIM) Program Manager, and why are they important?
To thrive as a CalAIM Program Manager, you need expertise in Medi-Cal policy, program implementation, and healthcare administration, often supported by a degree in public health, healthcare management, or a related field. Familiarity with state healthcare systems, data analytics tools, project management software, and regulatory compliance is typically required. Outstanding organizational, leadership, and stakeholder communication skills help drive collaboration and effective program delivery. These skills are crucial for successfully managing complex healthcare initiatives that aim to improve care coordination and outcomes for Medi-Cal beneficiaries.
What are some common challenges faced by professionals working in CalAIM implementation roles, and how can they be addressed?
Professionals working in CalAIM (California Advancing and Innovating Medi-Cal) implementation often encounter challenges such as coordinating care across multiple providers, navigating evolving state guidelines, and managing complex member needs. Success in these roles requires strong communication and collaboration skills, as well as adaptability to policy changes and new workflows. Building effective relationships with community-based organizations and regularly participating in training or knowledge-sharing sessions can help address these challenges and ensure smooth program execution.
What is CalAIM?
CalAIM stands for California Advancing and Innovating Medi-Cal. It is a multi-year initiative by the California Department of Health Care Services (DHCS) to improve and transform the Medi-Cal program. CalAIM aims to streamline services, better coordinate care for individuals with complex needs, and address social determinants of health such as housing and behavioral health. The initiative focuses on whole-person care and integrating healthcare delivery across physical, behavioral, and social services.
What is the difference between Calaim vs Claims Adjuster?
| Aspect | Calaim | Claims Adjuster |
|---|---|---|
| Required Credentials | Certification in insurance claims processing, relevant licenses | Insurance license, certification in claims adjusting often preferred |
| Work Environment | Insurance companies, third-party claims firms | Insurance companies, independent adjusting firms |
| Industry Usage | Used mainly in insurance claim processing roles | Commonly used in insurance claim assessment and settlement |
Both Calaim and Claims Adjuster roles involve evaluating insurance claims, but Calaim typically refers to a specialized certification or platform, whereas Claims Adjuster is a broader job title for professionals assessing and settling claims. Understanding these differences helps job seekers target the right roles and certifications in the insurance industry.
What are popular job titles related to Calaim jobs in Riverside, CA? For Calaim jobs in Riverside, CA, the most frequently searched job titles are:
What job categories do people searching Calaim jobs in Riverside, CA look for? The top searched job categories for Calaim jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Calaim jobs? Cities near Riverside, CA with the most Calaim job openings:
Full-time
Medical, Dental, Vision, Life, Retirement
Posted 9 days ago
Job description
OverviewDevelop and implement IEHP's population health management strategy and approach. Collaborate with key internal and external leaders, which includes conducting periodic population needs assessments, implementing strategies to systematically move farther upstream to impact the social determinants of health for IEHP members, identifying health disparities and system gaps in care, as well as ensuring that the health delivery system is focusing on evidence-based interventions and programming for the various segments of the population. Participate in the development and implementation of evidence-based approaches to address social determinants of health and community health assessment/improvement projects, in collaboration with internal departments, local and state agencies, local stakeholders, and funders. Oversee the department of Health Education, Promotion, and Prevention and the Community Behavioral Health Department and their functions, staff, and programs. Potentially other departments pending restructure. Oversee the department of Population Health and its functions, staff, and programs, inclusive of the Health Services Evaluation Team. Serve as a representative and spokesperson for IEHP in support of integration and population health activities in the Inland Empire with key county partners as well as State and National organizations and conferences. Ensure IEHP compliance with population health management regulatory requirements under NCQA, CalAIM/Medi-Cal 2024 contract, and Covered California. Oversee partnership joint operating meetings (ex. with counties) and MOUs related to population health as required in the 2024 Medi-Cal contract. May have a lead role in IEHP Strategic Plan initiatives in Optimal Care and Vibrant Health. Participate in State and industry work groups such as DHCS, DMHC, CHCF, NCQA, ACAP and CAHP to expand IEHP's influence on benefit design, regulations, and policy direction. Hire, train, and manage support staff, while monitoring and evaluating outcomes. Conduct performance reviews of each team Member within IEHP guidelines. Perform any other duties as required to ensure Health Plan operations and department business needs are successful. Qualifications
What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience!
Under the direction of the Vice President of Population Health, the Senior Director, Population Health provides leadership in the development and implementation of the IEHP Population Health strategy and program, with direct oversight over population health management regulatory requirements related to low-risk Members. The Senior Director works closely with key stakeholders and partners to ensure IEHP compliance with population health requirements under NCQA, Medi-Cal, and Covered California. The position directly supervises the IEHP Health Education, Promotion, and Prevention Department, the Community Behavioral Health Department, as well as the Population Health Unit, and coordinates activities with other IEHP leaders and external partners. The position is key in our partnership work with county public health departments on initiatives such as Community Health Assessments and Community Health Improvement efforts. The position also oversees partnership meetings and MOUs related to Population Health, as required in the 2024 Medi-Cal contract. The position may also have a key role in IEHP strategic plan initiatives under Optimal Care and Vibrant Health. The Senior Director, Population Health reports to the Vice President, Population Health & CalAIM. This classification is characterized by the responsibility to work collaboratively with senior management teams at IEHP and partner agencies, both locally and at the State/Nation level, to ensure that the strategic priorities of the organization are met, with a focus on improving population health in the Inland Empire. The Senior Director is motivated to work in a setting with a social mission.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Additional BenefitsPerks
IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.
- Competitive salary
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Life, short-term, and long-term disability options
- Career advancement opportunities and professional development
- Wellness programs that promote a healthy work-life balance
- Flexible Spending Account - Health Care/Childcare
- CalPERS retirement
- 457(b) option with a contribution match
- Paid life insurance for employees
- Pet care insurance
Education & Requirement
- Ten (10) years of experience in a population health-related role, inclusive of at least five (5) years in a health plan or health system required
- Experience in public health programming, research and evaluation, community collaborative work and/or policy analysis preferred
Master's degree in a related field from an accredited institution required
In lieu of a Master's degree, both items listed below are required:
Bachelor's degree in a related field from an accredited institution
- Possession of an active, unrestricted, and unencumbered clinical licensure issued by the appropriate California State Board are required (RN, LCSW, LMFT, MD/DO or similar)
Key Qualifications
- Administrative practices and procedures (including but not limited to quality assessment and improvement, program development and evaluation, evidence-based practice guidelines and pathways; principles of effective supervision and organization)
- Understanding of Managed Care Plan regulatory requirements
- Microcomputer applications such as Microsoft Office, Word, Excel, and Access helpful
Start your journey towards a thriving future with IEHP and apply TODAY!
Work Model LocationThis position is on a hybrid work schedule. (Monday & Friday - remote, Tuesday - Thursday onsite in Rancho Cucamonga, CA.)
Pay RangeUSD $220,043.20 - USD $302,536.00 /Yr.Employment Type: FULL_TIMEAbout Inland Empire Health Plan
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
Rancho Cucamonga, CA, US
Year founded
1995