Chief Operating Officer; COO

We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.

We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.

We are hoping you will join us as a Chief Operating Officer (COO) and help shape the future of healthcare where you’ll be an integral part of our Executive Office team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders.

This position has been approved to be Full Office.

The Chief Operating Officer (COO) will serve as a member of the executive team and contribute to strategic planning for the organization. You will be a key leader within the health plan and have the authority and accountability to lead the areas assigned to next-level capabilities and operational efficiencies consistent with the strategic plan, goals, and objectives for Cal Optima Health.

In this role, you will anticipate needs, continuously improve processes, communicate effectively and leverage resources while balancing and achieving set accountabilities within the constraints of limited resources. Additionally, you will be directly responsible for health plan operations, the provider network, information security, and the Executive Directors who oversee these areas. Together, we are building a stronger, more equitable health system.

• 90% - Strategic Leadership & Operational Management
  • 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.
  • Provides high-level oversight of Claims, Customer Service, Grievances & Appeals, Coding Initiatives, Provider Contracting, Provider Relations, Provider Data Management Services, and Information Security departments.
  • Manages cross-organizational collaboration for agency-wide projects and initiatives, ensuring effective operations and consistent delivery of results and metrics.
  • Provides updates and presentations to Cal Optima Health’s Board of Directors.
  • Deploys strategies, develops workflows, and maintains ongoing operational compliance and reporting to satisfy and exceed state and federal standards.
  • Identifies, develops and implements best practices.
  • Develops, administers and ensures adherence to the department’s annual budget.
  • Hires and retains capable staff to build a successful talent base that executes strategy and operations plans.
  • Leads succession planning and develops leaders to ensure organizational continuity.
  • Engages regularly with providers, members, employees, auditors and regulators.
• 10% - Other
  • Completes other projects and duties as assigned.

• Bachelor’s degree PLUS 8 years of experience in managed-care operations at an executive level required; an equivalent combination of education and experience sufficient to successfully perform the…