Sr Manager, Covered California; Sr. Manager II

Sr Manager, Covered California (Sr. Manager II)

Join Cal Optima as a Senior Manager in Medical Management. You will shape future healthcare while working in a mission‑driven, community‑based organization.

Full Telework. If telework is approved, you work within California. Partial Telework requires in‑office work in Orange, CA two days a week.

• Lead development and implementation of medical and behavioral health clinical operations and medical management programs for new product lines, including commercial products.
• Manage regulatory and programmatic aspects, ensuring compliance and effective execution.
• Collaborate with health network leadership, IT, finance, compliance, and senior leaders to define objectives, structure governance, and coordinate cross‑functional efforts.
• Oversee regulatory filings, program submissions, and improvement initiatives across internal and delegated entities.
• Provide program policy and operations oversight (50%).
• Direct leadership responsibilities (45%) – cultivate a mission‑driven culture, hire, coach, and manage teams, develop processes, and lead implementation of new clinical and medical management programs.
• Other duties as assigned (5%).

• Bachelor’s degree in health administration, public health, or related field plus five years of experience in managed care plan or other health care related field, including at least two years in government programs (Medicaid, Medicare, Covered California).
• Three years of experience in a management/leadership role.
• Preferred:
  Master’s degree in social work, psychology, or related field.
• Experience interfacing with local, state, or federal regulators.
• Behavioral health clinical operations knowledge and experience.

• Pay Grade 317: $132,969 – $212,751.
• Full Telework and a comprehensive benefits package, including CalPERS pension program, generous PTO, wellness programs, tuition reimbursement, and professional development opportunities.

Cal Optima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. Cal Optima Health prohibits unlawful discrimination based on race, religion, color, national origin, ancestry, mental or physical disability, marital status, sex, gender, age, sexual orientation, immigration status, veteran status, or any characteristic protected by federal, state, or local laws.