Brief job information:
The Covered California Account Manager provides program management support of CCHP’s participation with Covered California. The Account Manager actively participates in internal and external project meetings, produces planning and communication documents and provides support for the COO. She/he must demonstrate effective communications with senior managers internally within the organization and externally within community partners, practitioners, vendors, suppliers and Covered California staff to ensure strategic alignment with CCHP.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Coordinates and staffs Covered California related meetings and forums to monitor performance, track new program requirements and ensure strategic alignment.
- Manages the bid and renewal cycle of CCHP’s participation with Covered California.
- Maintains project work plans, issues logs, reporting and projects deadline and other related files in an orderly fashion.
- Serves as the primary resource for Covered California related submissions regarding Qualify Health Plan (QHP) Individual Market and Covered California Small Business (CCSB).
- Analyzes and issues resolution associated with California Health Eligibility, Enrollment, and Retention System (CalHEERS). Acts as a primary liaison to communicate with CalHEERS, QHP Individual Market, CCSB and Pinnacle for all eligibility issues.
- Assists in planning and communications related to the Medical, Quality Improvement and Health Management to ensure CCHP developing and implementing policies and practices that can promote improvements in the entire care delivery system.
- Plans and facilitates annually Negotiation and Quality Improvement Strategy Meetings with Covered California for negotiation and evaluation purposes regarding any extension of the Agreement and the recertification process for subsequent years. Makes formal presentations to various senior level audiences.
- Provides supervision to the Covered California Account Associate for ensuring high standards of fixing members’ eligibility issue.
- Responsible for oversight of all departmental activities, training, and performance management to advance the organization’s customer service and member retention efforts and to ensure the all quality and compliance standards are met during the term of the annual contract.
- Updates policy regarding to Covered California and notify CCHP internal department for execution. Delegates and Works closely with all operations departments to build a team environment between all areas to optimize cross-training and support.
- Generates meeting minutes as warranted by the nature of the meetings.
- Accepts and performs other duties as assigned.
- Must possess and consistently demonstrate the following competencies:
- BS/BA in business administration or health care related field of study, or AA degree with equivalent health care work experience
- Two years prior experience in a health care environment
- Attain or maintain Plan Based Enroller Certification for respective enrollment year.
- Strong analytical and problem solving skills
- Excellent business communication skills (oral, written, and presentation)
- Results and detail oriented self-starter
- Ability to work within a very fast-paced, quickly evolving organization.
- Strong interpersonal skills with an ability to work effectively with a wide range of constituencies
- Proficient with Microsoft Office applications including MS Office; project management software experience preferred
- Able to lift up to 30 pounds
- Use proper body mechanics when handling equipment
- Standing, walking and moving 50% of the day.
- Complies with CCHP Compliance Handbook including Code of Ethics and all statutes, regulations, guidelines applicable to federal and state programs. Responsibilities include, following the guidelines and reporting suspected violations of any statute, regulations, agreements or guidelines applicable to all healthcare programs.