Director, Provider Network Operations (Director Iii)

Department(s): Provider Relations
Reports To: Executive Director Network Operations
FLSA status: Exempt
Salary Grade: S - $154,000 - $270,512

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on Monday, November 20, 2023 at 11:59 PM.  Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.   

**This position is eligible for partial telework in California.**  

About CalOptima Health

CalOptima Health is the single largest health plan in Orange County, serving 880,000 members, or one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. If you're looking for an opportunity to work for an organization dedicated to improving local health care and serving the needs of the most vulnerable, we encourage you to join CalOptima Health.

About the Position

The Director III (Provider Network Operations) will lead the development and implementation of outcome-driven strategies to engage, support and build the capacity of CalOptima Health's provider delivery system. The incumbent will be responsible for initiating and/or deepening partnerships resulting in CalOptima Health increasing its access to services and the quality of services available to members. In addition, the incumbent will work across the organization to enhance quality programs and performance outcomes for the Provider Network. The incumbent will be a thought leader and contributor to program approach, planning, change management and delivery.

Duties & Responsibilities:

• 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.
• Partners with leadership to set initiative, execution, approach and mobilize resources across all phases of delivery.
• Manages, mentors and leads staff.
• Conducts assessments (e.g., key informant interviews, asset mapping, etc.) to gauge the extent of CalOptima Health's provider partnerships and the long-term potential to build out those relationships, to the benefit of CalOptima Health's membership and Orange County overall.
• Creates and supports the execution of a strategy to formalize CalOptima Health's partnerships, including opportunities to deepen the impact of those relationships and share with stakeholders the value and impact of that work.
• Designs, implements and oversees a structure to monitor the success, challenges, growth and impact of partnerships, including the return on investment of resources deployed to support the strategy and capacity building efforts.
• Collaborates with leadership and across departments to ensure the successful launch of key CalOptima Health initiatives and to ensure it functions successfully within the CalOptima Health environment.
• Coordinates with other support resources/teams as needed for key deliverables.
• Works closely with CalOptima Health's leadership team to leverage opportunities for program enhancement and growth in the context of CalOptima Health's strategic plan.
• Completes other projects and duties as assigned.

Experience & Education:

• Bachelor's degree in Business Administration, Healthcare Management or related field required.
• 7 years of experience in program development for vulnerable populations, including strategic planning for a start-up program and implementing the program or related experience required.
• 4 years of progressive leadership experience, including direct supervision of staff required.
• Experience in Provider Network or Management Service Organization (MSO) required.
• Experience in developing sound and responsible business plans and financial models required.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.

Preferred Qualifications:

• Master's degree.
• Experience working at a director level, with a successful track record of managing Provider Networks and launching new programs and initiatives.
• Experience and aptitude for working in a highly matrixed, mission-driven public agency or government environment.
• Experience in high level executive engagement with hospital and physician organizations, Federally Qualified Health Centers (FQHC's) and MSO's.  

Physical Demands and Work Environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Physical demands: While performing duties of job, employee may be required to move about the organization. Employee must be able to sit for extended periods of time, as well as work at the computer for long periods. Employee is required to use hands and fingers, especially for typing on the computer and using the mouse. Employee must be able to communicate, particularly for regular phone use, in meetings and face-to-face interaction. Must be able to tolerate high level of stress and be able to operate under pressure.

• Work Environment: Typical office environment with minimal noise levels and controlled office temperatures. Fast paced work environment.

About our Benefits & Wellness options:

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options. 

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

CalOptima Health is an equal employment 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 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.