Sr Manager, Member Retention & Outreach; Sr Manager

Sr Manager, Member Retention & Outreach (Sr Manager I)

Company:
Cal Optima

Join us in this amazing opportunity to lead member retention and outreach programs for Cal Optima’s Medicare Advantage line of business. You will be part of the Operations Management team, helping to strive for excellence while serving member health with dignity.

• Partial telework is approved. Must be based in California and attend the office in Orange, CA at least two (2) days per week.

• 50% Leadership Functions
  • 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.
  • Develops a comprehensive, annual Retention & Outreach Strategy Plan focused on reducing controllable disenrollments, improving Stars and CAHPS performance, and strengthening overall membership stability.
  • Launches and scales member outreach and support programs— including onboarding, re‑engagement, ambassador and repeat‑caller initiatives—to improve retention and reduce grievances.
  • Uses data and analytics to identify predictive risk indicators, inform proactive retention efforts and guide program improvements.
  • Defines key performance indicators (KPIs) and develops dashboards and scorecards to monitor program effectiveness.
  • Utilizes matrix management and directs and/or coordinates staff throughout the organization in the implementation of strategic growth and retention plans.
  • Hires, manages, trains, reviews and sets goals for staff, including assisting in team engagement and management.
  • Manages and coaches teams through activities such as building strong relationships, documenting initiatives and discussions, identifying gaps/issues/solutions, standardizing tools/templates, implementing quality departmental initiatives and reporting to stakeholders and management team.
  • Manages and coordinates the day‑to‑day assignment of resources and shifts in work and priorities based on departmental needs.
  • Develops, establishes and updates department processes to maintain operational excellence.
  • Fosters ongoing relationships and mutually beneficial partnerships with internal Cal Optima Health departments and external organizations.
• 45% Program Oversight
  • Conducts regular analysis of member disenrollment trends and collaborates with cross‑functional partners as well as external provider networks to resolve systemic issues contributing to attrition.
  • Partners with Quality and Customer Service teams to align outreach with CAHPS and HOS drivers, improving key member experience domains such as access, communication, and coordination of care.
  • Collaborates with internal departments to ensure analysis and feedback informs operational, services and process improvements.
  • Establishes and leads a Community Engagement and Partnerships function that strengthens local presence and member connection by enhancing Cal Optima One Care’s presence in the community through community events, educational outreach and relationship building efforts that reinforce retention goals.
  • Collaborates with Cal Optima Health departments to plan and execute community outreach activities including member and provider outreach events, and to enhance visibility, trust and engagement.
  • Develops and oversees multi‑touch onboarding campaigns for new members and year‑round engagement campaigns (e.g., benefit education, preventive care reminders) to close gaps in care and improve experience.
  • Partners with internal teams to identify and coach lower performing medical groups and providers on strategies to improve CAHPS‑related experience measures, ensuring alignment between provider performance, member satisfaction, and overall retention goals.
  • Collaborates and supports organizational member experience initiatives including CMS Star Program operational initiatives and Hierarchical Condition Category (HCC) maintenance and improvement activities.
  • Ensures implementation of One Care member retention initiatives…