L.A. Care Health Plan

Implementation Specialist

• Provide leadership and direction for operational execution and lifecycle management of Commercial products
• Lead the end-to-end operational implementation of Commercial product initiatives
• Develop and manage detailed implementation plans, timelines, and cross-functional coordination
• Serve as operational liaison with internal and external stakeholders
• Establish governance structures for product lifecycle management
• Communicate with senior leadership and executives, provide reports on performance and progress towards objectives

Director, Commercial Product Implementation

Software Engineer

• Provide business insights and serve as a focal point for data review and remediation
• Develop complex formal reports for government entities
• Work closely with I.T. enterprise data warehouse and application development teams
• Represent the Department at key multi-disciplinary and technical meetings
• Develop expert level knowledge of the systems data structures
• Provide high level advice and guidance to management on systems development and data integration
• Submit a range of mandatory provider network reports for local, state, and federal government entities
• Research, audit and analyze complex data
• Oversee daily workflow and lead assigned staff

Lead SQL Reports Developer

Compliance

• Responsible for supporting the effective operation of the organization’s compliance framework
• Focuses on implementing and maintaining compliance policies and procedures
• Manages the governance, risk, and compliance (GRC) system to meet regulatory and organizational requirements
• Oversees the exclusion monitoring process and ethics and civil rights reporting channels
• Provides regular reporting and collaborates with other departments to address identified issues
• Coordinates compliance communications, preparing materials for internal committees and the Board of Governors
• Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports
• Participates and makes recommendations on the department's strategic planning and/or long-term decision-making
• Implement and maintain processes that support the organization’s compliance framework
• Coordinate with key stakeholders across the organization to ensure consistent and efficient execution of compliance activities
• Manage complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval
• Responsible for reporting, budgeting, and policy implementation
• Translate regulatory updates into practical steps for implementation
• Oversight of organizational requirements which includes enterprise compliance with training requirements
• Manage the review, communication, and escalation of organizational policies and procedures
• Administer the GRC program to support effective documentation, tracking, and reporting of compliance activities
• Ensure cross-functional coordination for timely issue resolution and follow-up
• Maintain current knowledge of regulatory requirements related to exclusion activities
• Prepare regular reporting to support transparency and accountability
• Support internal communication efforts related to compliance initiatives

Manager, Enterprise Compliance

Communications

• Oversee all Marketing areas and the Creative Services unit
• Support senior leadership in change management efforts
• Direct and enhance all branding efforts for L.A. Care's products and services
• Develop strategic initiatives to achieve and sustain market growth
• Oversee marketing operations and sales support functions
• Lead the Annual Marketing Plan development, actualization and monitoring efforts
• Manage features of annual L.A. Care Brand marketing programs
• Develop and execute strategies to build a positive brand identity and attract new members
• Direct all aspects of running an efficient team, including hiring, supervising, coaching and training direct reports

Director, Marketing Strategy – Creative and Member Communications

Support Engineer

• Managing complex system configurations, health plan implementations and conversions
• Accurate interpretation of specific state/federal and/or business requirements
• Supporting integration and business process activities that utilize configuration as part of the end-to-end solution
• Identifying opportunities for improvement and suggesting ways to bridge the gap between inter-dependent departments
• Triage possible issues identified and implement applicable remediation
• Redesign complex business concepts resulting in correct processing conflicts
• Manage daily workflow and lead the work of assigned staff
• Mentor and coach team members and act as a resource

Lead Systems Configuration Technical Analyst

Program Manager

• Oversees one or more programs ensuring that department management and key stakeholders define the program goals
• Responsible for developing program assessment protocols for effectiveness and quality improvement
• Maintains the program standards of quality and performance
• Oversees the program budget for maximum utilization of resources
• Participates and recommends in setting program goals and objectives
• Ensure team members have the resources needed to meet their objectives
• Provide recommendations on financial management of assigned programs including developing, tracking, and updating budgets
• Monitors program operations for quality, efficiency and effectiveness
• Utilizes a client relationship management (CRM) to organize information and facilitate outreach communications
• Develop and implement annual work plans

Program Manager II

Manager

• End-to-end management of IT change control and software releases
• Oversee planning, scheduling, and deployment of software releases
• Develop and maintain release documentation and metrics
• Proactively identify, assess, and mitigate risks associated with software releases
• Lead and mentor the release management team

Information Technology Release Manager III

Analyst

• Collaborate with business stakeholders to gather and analyze requirements
• Translate business needs into functional and technical specifications
• Partner with internal teams to ensure accurate solution delivery
• Support User Acceptance Testing (UAT) and production issue analysis by identifying root causes and corrective actions
• Perform advanced system testing and validate data accuracy
• Document technical requirements, business workflows, data mappings, standard operating procedures, and integration points
• Lead complex end-to-end business and technical analysis for workflows and enterprise applications
• Ensure compliance with Protected Health Information (PHI)/ Personally Identifiable Information (PII) handling, Health Insurance Portability and Accountability Act (HIPAA), and healthcare data security standards
• Ensure alignment with Agile delivery frameworks and Continuous Integration and Continuous Delivery (CI/CD) practices
• Provide subject matter expertise on Health Plan systems and processes
• Monitor and troubleshoot complex system issues and coordinate resolution
• Support staff by assisting with troubleshooting difficult issues related to deployment
• Evaluate and recommend system enhancements, configurations, integrations, and data flows to improve operational performance
• Apply subject matter expertise in evaluating business operations and processes
• Identify areas where technical solutions would improve business performance
• Consult across business operations, provide mentorship, and contribute specialized knowledge
• Ensure that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices
• Provide training and recommend process improvements as needed
• Perform other duties as assigned

System Analyst III

Administration

• Responsible for daily administration, monitoring, and optimization of identity and access management systems
• Support secure user provisioning, de-provisioning, access reviews, and enforcement of RBAC, MFA, and conditional access policies
• Implementation and ongoing support of the Saviynt Identity Governance platform
• Ensure compliance with HIPAA, HITRUST, and CMS regulations
• Administer and maintain IAM lifecycle processes including provisioning and access certification
• Monitor IAM systems for anomalies, policy violations, and access risks
• Provide training and recommend process improvements as needed

Identity Access Management Administrator III

• Responsible for supporting Community Health projects designed to improve the managed care performance of the L.A. County safety net and the health of vulnerable L.A. Care members.
• Fulfilling a broad range of analytical, planning, engagement, and implementation functions.
• Performing research and data analysis, operational and conceptual problem-solving, building partnerships, and project planning, implementation, and monitoring.
• Initiating and developing strong interpersonal relationships with both internal and external business partners to facilitate joint decision-making and successful project implementation.
• Helping to achieve the triple aim of better health quality outcomes, better patient experience of care, and lower cost of care.

Community Health Program Manager II

• Oversees one or more programs ensuring that the department management and key stakeholders define the program goals.
• Develops program assessment protocols for effectiveness and quality improvement.
• Maintains the program standards of quality and performance.
• Oversees the program budget for maximum utilization of resources.
• Participates and recommends in setting program goals and objectives.
• Ensure team members have the resources needed to meet their objectives.
• Provide recommendations on financial management including budgets, projections, and actuals.
• Monitors program operations for quality, efficiency and effectiveness.
• Utilizes a client relationship management (CRM) or other system to organize information and facilitate outreach communications, perform forecasting, and measure the performance of programs.
• Develop and implement annual work plans; ensure timely and high-quality reviews and submissions of deliverables.
• Work with key stakeholders on program implementation and facilitate communications with cross-functional departments on the status of ongoing activities.

Program Manager II – Regulatory Operations, Delegation Oversight

Actuary

• Responsible for the overall management and oversight of staff
• Monthly financial reporting and related analysis and reporting
• Assistance with the submission of health care experience reports and financial regulatory filings
• Review and analysis of DHCS, CMS, and/or Covered CA payment rates to L.A. Care
• Work with risk adjustment models for all lines of business
• Manage risk score data analysis and reporting
• Review rates and other at-risk payments from DHCS, CMS, Covered CA
• Manage staff, including monitoring performance, training, and encouraging process enhancements
• Manage complex projects, engaging and updating key stakeholders, developing timelines
• Responsible for reporting, budgeting, and policy implementation

Manager, Actuarial Services

• Support monthly, quarterly, and annual financial reporting, budgeting and audit processes
• Analyze claims and enrollment data to identify trends and provide actionable insights
• Collaborate with other Actuarial team members
• Perform data validation and quality checks to ensure the accuracy of actuarial analyses
• Document methodologies, assumptions, and results in a clear and organized manner
• Contribute to regulatory filings and compliance reports as needed
• Assist in ad hoc data analyses as needed
• Develop understanding of industry trends, regulatory changes, and actuarial best practices
• Perform other duties as assigned

Actuarial Analyst I

• Oversees multiple complex programs in the department
• Designs and manages the implementation, operations, and the evaluation of strategic programs or functions
• Aligns program goals with the organizational strategy
• Defines and maintains standards for program management within the department
• Develops program goals and objectives
• Ensures team members have the resources needed to meet their objectives
• Responsible for defining the metrics, quality standards, and documentation required for consistent project management and execution
• Serves as SME for all programmatic processes and procedures
• Provides strategic direction to program start-up and closeout activities
• Directly responsible for the financial management of assigned programs
• Designs and orchestrates the delivery of applicable communication to staff and management
• Oversees the development and implementation of annual work plans
• Collaborates with key stakeholders on program implementation and facilitates communications with cross-functional departments
• Provides recommendations and guidelines on strategic business development
• Manages and troubleshoots issues
• Provides training, recommends process improvements, and mentors junior level staff

Program Manager III

Business Operations

• Monitor and track operational issues, ensuring timely escalation and resolution.
• Facilitate communication between IT teams, business stakeholders, and support teams.
• Prepare and maintain operational dashboards and reports for leadership.
• Support compliance activities related to regulatory changes and audit requirements.
• Assist in backlog management and prioritization of operational tasks.
• Participate in strategic projects and provide operational insights.
• Identify process improvement opportunities and recommend solutions.
• Perform other duties as assigned.