Lead planning, implementation, and ongoing management of Community Supports programs, ensuring alignment with CalAIM, DHCS APLs, contract requirements, and organizational strategy.
Translate policy and regulatory guidance into operational workflows, job aids, and scalable program processes.
Identify program risks, gaps, and opportunities; develop mitigation strategies and continuous improvement plans.
Oversee day-to-day operations of assigned Community Supports programs, ensuring performance targets, service delivery standards, and timelines are met.
Develop, maintain, and monitor program workflows, Standard Operating Procedures (SOPs), and operational tools.
Partner with Finance, Claims, IT, Compliance, and Quality teams to ensure end-to-end operational integrity (referrals, authorizations, billing, reporting).
Ensure appropriate escalation and resolution of complex operational issues.
Serve as primary programmatic lead for Community Supports providers.
Oversee provider onboarding, readiness, and ongoing monitoring activities.
Collaborate with provider partners to improve performance, resolve operational challenges, and support compliance with contractual and regulatory requirements.
Lead corrective action planning when performance, compliance, or quality issues are identified.
Ensure Community Supports programs comply with applicable APLs, policy guidance, contracts, and audit requirements.
Support internal and external audits, including documentation review, corrective actions, and response development.
Partner with Compliance and Quality teams to develop monitoring tools and oversight frameworks.
Maintain up-to-date knowledge of evolving state and federal requirements impacting Community Supports.
Define and monitor KPIs, utilization trends, provider performance metrics, and member outcomes.
Use data to drive program improvements, inform leadership decisions, and support reporting requirements.
Prepare executive-level reports, dashboards, and presentations summarizing program performance and risks.
Act as a key liaison with internal leaders, external partners, counties, and state agencies as needed.
Lead cross-functional workgroups and meetings related to Community Supports initiatives.
Communicate complex program information clearly to diverse audiences.
Provide guidance, coaching, and mentorship to Program Managers and other team members.
Lead special projects and enterprise-wide initiatives related to Community Supports.
Contribute to team development, knowledge sharing, and best practice standardization.

Requirements

A minimum of five (5) years of progressively responsible experience in healthcare program management, population health, or Community Supports-related services
Demonstrated experience with CalAIM Community Supports, Medicaid managed care, or social services programs
Application experience of standard Project Management Practices
Master’s degree from an accredited institution required
In lieu of a Master’s degree, a relevant certification (i.e., PMP, PgMP, CBAP or PMI‐PBA) and a bachelor’s degree from an accredited institution is required
Valid California Driver’s License preferred
Advanced knowledge and understanding in the following areas:
Developing plans with project management and cross-organization coordination
Key operational information and key organizational tactical / strategic information through the effective implementation of data initiatives
Data Initiatives including data trending analyses, data profiling, data mining, data analysis, and promoting a data-aware culture throughout an organization
Understanding and sensitivity to a multi-cultural environment and community
Healthcare regulations, contracts, and compliance requirements
Strong interpersonal skills, strong project management skills, and strong issue management skills.
Microcomputer applications: spreadsheet, database, and word processing
Must have excellent writing, interpersonal communication, and organizational skills.

Benefits

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

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard skills

healthcare program managementpopulation healthCalAIM Community SupportsMedicaid managed careproject managementdata analysisdata trending analysesdata profilingdata miningoperational workflows

Soft skills

interpersonal skillsproject management skillsissue management skillscommunication skillsorganizational skillsleadershipmentorshipcollaborationcoachingproblem-solving

Certifications

PMPPgMPCBAPPMI-PBA