Director, Chronic Condition Self-Management (Director III)

Director, Chronic Condition Self-Management (Director III)

CalOptima

CalOptima Health is seeking a highly motivated an experienced Director, Chronic Condition Self-Management (Director III) to join our team. The Director for Chronic Condition Self-Management will lead the development, implementation and evaluation of all activities and personnel engaged in chronic condition self-management departmental operations. The incumbent will provide leadership, oversight and direction to the Chronic Condition Self-Management personnel and department to ensure compliance with all local, state and federal regulations, and accreditation standards. The incumbent will serve in a leadership role, interacting with all levels of CalOptima Health staff, departments and external stakeholders, including the board of directors, executive staff, members, providers, health network management, legal counsel, local, state and federal representatives, and representatives of other agencies to implement programs aligned with the organization's strategic goals.

Position Information:

• Department: Equity and Community Health
• Salary Grade: 322 - $192,386 - $307,817 ($92.49 - $147.9891)
• Work Arrangement: Partial Telework
  
  **This position is eligible for telework in California.**

Duties & Responsibilities:

• 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.
  • Hires, manages, trains, reviews and sets goals for assigned staff.
  • Responsible for overall direction and clinical oversight of chronic condition self-management programs including planning, organizing and directing all activities, staffing, reporting, and performance improvement in the delivery of chronic condition self-management programs.
  • Works closely with leadership team to leverage opportunities for program enhancement and growth in the context of CalOptima Health's strategic plan(s).
  • Provides leadership and clinical oversight of multidisciplinary teams in the delivery of chronic condition self-management program initiatives.
    
    
• 45% - Program Oversight
  • Collaborates with internal and external stakeholders to develop programs designed with a focus on health equity.
  • Completes assessments of populations, community needs and social drivers of health in the development and implementation of culturally sensitive and diverse health education, chronic condition and maternal health programs.
  • Collaborates with internal departments and external stakeholders in developing goals, priorities, processes and outcome measures for CalOptima Health's chronic condition self-management programs.
  • Serves as ambassador and liaison with external stakeholder groups including government entities, academic institutions, community-based organizations, hospitals, community collaboratives/workgroups and others to ensure comprehensive support for our members.
  • Develops, reviews and updates chronic condition self-management departmental policies and procedures to support compliance with Medicaid state regulations, Centers for Medicaid and Medicare (CMS) requirements, National Committee for Quality Assurance (NCQA) standards and the Department of Healthcare Services (DHCS) Population Health Management (PHM) program.
  • Serves as a resource to departmental staff, internal departments, CalOptima Health providers, health networks and the community.
  • Develops and maintains chronic condition self-management departmental budget including approval of operating and capital budgets and performance monitoring to prevent budget variance.
  • Participates in internal committees and workgroups such as the PHM steering committee and Quality Improvement and Health Equity committee.
  • Monitors performance, programmatic outcomes and reports to the board of directors, board committees, executive leadership and CalOptima Health committees.
  • Serves as lead for regulatory, NCQA and internal audits, including developing and monitoring of corrective action plans.
    
    
• 5% - Completes other projects and duties as assigned.

Minimum Qualifications:

• Bachelor's degree PLUS 7 years of related experience in a managed care environment, preferably with Medicare and Medicaid/Medi-Cal populations, required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
  
• 5 years of progressive leadership experience required.
  
• Experience in chronic condition program development for vulnerable populations, including strategic planning and implementing the program.

Preferred Qualifications:

• Master's degree in relevant field.
  
• Current unrestricted RN license to practice in the state of California.
  
• Experience in a government or public environment.

Required Licensure / Certifications:

• n/a

Knowledge & Abilities:

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):

• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Work Environment:

If located at the 500, 505 Building or a remote work location:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• There are no harmful environmental conditions present for this job.
• The noise level in this work environment is usually moderate.

If located at PACE:

• Work is typically indoors in a clinical setting serving the frail and elderly.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

If located in the Community:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• Employee will occasionally work outdoors in varied temperatures.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

About CalOptima Health:
CalOptima Health is the single largest health plan in Orange County, serving 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. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!

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, 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. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the 2025 CalOptima Health Benefits Guide regarding our comprehensive benefits and wellness package.

IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS

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 April 11, 2025 at 9:00 PM (PST). 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.

The selection process may include, but is not limited to, a skills assessment, phone screen and interview.

The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet.

Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application.

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 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 at (714) 246-8400 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.


To apply, please visit: https://jobs.caloptima.org/jobs/director-chronic-condition-self-management-director-iii-505-city-parkway-west-california-united-states







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