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<h4>Overview</h4>LMI is seeking an experienced Program Manager (PM) to lead the Centers for Medicare &amp; Medicaid Services (CMS) Next Generation Desktop (NGD) program. This position supports CMS’s mission to modernize its customer service capabilities, streamline call center operations, and improve service delivery to beneficiaries and providers. The PM serves as the central point of contact with CMS for all aspects of program delivery, risk management, performance, and communication. Working closely with the Sr. Technical Program Manager (TPM) and Technical Lead, this individual ensures program goals are achieved on schedule, within scope, and in compliance with contract requirements. The ideal candidate brings a deep understanding of CMS, operations, and policy, as well as experience leading large, multi-stakeholder programs focused on call center modernization, service delivery, and organizational effectiveness. LMI is a new breed of digital solutions provider dedicated to accelerating government impact with innovation and speed. Investing in technology and prototypes ahead of need, LMI brings commercial-grade platforms and mission-ready AI to federal agencies at commercial speed. Leveraging our mission-ready technology and solutions, proven expertise in federal deployment, and strategic relationships, we enhance outcomes for the government, efficiently and effectively. With a focus on agility and collaboration, LMI serves the defense, space, healthcare, and energy sectors—helping agencies navigate complexity and outpace change. Headquartered in Tysons, Virginia, LMI is committed to delivering impactful results that strengthen missions and drive lasting value.<h4>Responsibilities</h4>Program Leadership &amp; Oversight<ul><li>Coordinate closely with the Technical Program Manager to ensure alignment across all program activities, including requirements, delivery, budget, and performance.</li><li>Organize, direct, and provide oversight for the contract, ensuring objectives are met and client expectations are exceeded.</li><li>Serve as the primary point of contact with CMS for all program risks, issues, and communications.</li><li>Oversee daily program operations, managing priorities, timelines, and resources to deliver high-quality outcomes.</li><li>Provide clear direction to project teams and subcontractors, fostering accountability and collaboration.</li></ul>Contract &amp; Financial Management<ul><li>Monitor and track the program’s budget throughout its lifecycle, ensuring sound financial management and timely delivery.</li><li>Ensure adherence to contract requirements, providing proactive solutions to address emerging issues such as staffing, resource allocation, or changing specifications.</li><li>Oversee subcontractor activities, ensuring all partners deliver high-quality work that meets program goals.</li><li>Maintain compliance with federal acquisition regulations, legal requirements, and all contract obligations.</li></ul>Stakeholder Engagement<ul><li>Act as a trusted partner and advisor to CMS leadership, providing updates, reports, and recommendations to address risks and improve outcomes.</li><li>Communicate program progress and challenges clearly to technical and non-technical stakeholders.</li><li>Facilitate collaboration among CMS components, subcontractors, and other program partners.</li></ul>CMS Expertise &amp; Strategic Alignment<ul><li>Apply a strong understanding of CMS policies, operations, and priorities, including knowledge of Medicare, Medicaid, CHIP, and value-based care initiatives.</li><li>Ensure program activities align with CMS’s broader goals around modernization, service efficiency, and data-driven decision-making.</li><li>Anticipate program needs and emerging risks, providing proactive recommendations for improvement.</li></ul>Continuous Improvement &amp; Team Leadership<ul><li>Promote a culture of accountability, collaboration, and continuous improvement.</li><li>Mentor team members and cultivate strong working relationships with CMS counterparts.</li><li>Identify opportunities to improve efficiency, strengthen stakeholder engagement, and expand LMI’s value to CMS through innovation and partnership</li></ul><h4>Qualifications</h4>Minimum Requirements:<ul><li>Bachelor’s degree in business administration, management, public health, or related field.</li><li>10+ years of experience leading large, complex federal programs, with at least 5 years in program management supporting healthcare or human services initiatives.</li><li>Proven experience managing program delivery, risk, and compliance within a federal contracting environment.</li><li>Strong understanding of CMS organizational structure, program operations, and policy frameworks.</li><li>Demonstrated ability to lead diverse teams, manage subcontractors, and drive results under tight deadlines.</li><li>Excellent interpersonal, written, and verbal communication skills, including experience briefing senior government officials.</li><li>Ability to obtain and maintain a Public Trust clearance.</li></ul>Preferred Qualifications:<ul><li>Master’s degree in business, public administration, or healthcare management.</li><li>PMP, PgMP, or similar program management certification.</li><li>Prior experience supporting CMS call center, digital service, or modernization efforts.</li><li>Experience with organizational change management and stakeholder engagement.</li><li>Demonstrated success managing budgets and performance-based contracts.</li></ul><h4> LMI is an Equal Opportunity Employer. LMI is committed to the fair treatment of all and to our policy of providing applicants and employees with equal employment opportunities. LMI recruits, hires, trains, and promotes people without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, pregnancy, disability, age, protected veteran status, citizenship status, genetic information, or any other characteristic protected by applicable federal, state, or local law. If you are a person with a disability needing assistance with the application process, please contact <a href="mailto:accommodations@lmi.org" target="_blank">accommodations@lmi.org</a> Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information. Need help finding the right job? </h4>We can recommend jobs specifically for you!Click here to get started.

Program Manager

<h4>Overview</h4>LMI seeks an experienced&nbsp;Research Psychologist (Survey Subject Matter Expert) to support the U.S. Army’s Holistic Health &amp; Fitness (H2F) initiative as a member of the Research functional team within the H2F Program Support Team. This position requires aSecret security clearance. This position is an on-site psition in Newport News, VA.The Research Psychologist (Survey SME) is responsible for supporting the&nbsp;design, implementation, analysis, and interpretation of survey-based research instruments&nbsp;used to assess behavioral, cognitive, psychosocial, and organizational dimensions of Soldier readiness and performance within the&nbsp;Holistic Health and Fitness Management System (H2FMS).This role is&nbsp;applied and analytic, focused on ensuring survey methods are scientifically sound, appropriately implemented, and effectively integrated into H2FMS analytics and user-facing outputs. The Research Psychologist does&nbsp;not&nbsp;independently define research strategy or policy and does&nbsp;not&nbsp;conduct clinical assessment or treatment. All work is performed under Government direction and TPM coordination.LMI is a new breed of digital solutions provider dedicated to accelerating government impact with innovation and speed. Investing in technology and prototypes ahead of need, LMI brings commercial-grade platforms and mission-ready AI to federal agencies at commercial speed.Leveraging our mission-ready technology and solutions, proven expertise in federal deployment, and strategic relationships, we enhance outcomes for the government, efficiently and effectively. With a focus on agility and collaboration, LMI serves the defense, space, healthcare, and energy sectors—helping agencies navigate complexity and outpace change. Headquartered in Tysons, Virginia, LMI is committed to delivering impactful results that strengthen missions and drive lasting value.<h4>Responsibilities</h4><ul><li>Support development and refinement of&nbsp;survey instruments&nbsp;assessing behavioral, cognitive, psychosocial, and organizational factors related to H2F objectives.</li><li>Apply accepted research and psychometric principles to support validity, reliability, and appropriate use of survey measures.</li><li>Assist in aligning survey content with Government-approved research objectives and constructs.</li><li>Support administration of surveys in coordination with Government stakeholders and technical teams.</li><li>Assist in monitoring survey execution, response quality, and data completeness.</li><li>Coordinate with data engineers to support ingestion and structuring of survey data within H2FMS.</li><li>Support analysis and interpretation of survey data to identify trends, patterns, and insights relevant to readiness and performance.</li><li>Collaborate with epidemiologists, tactical sports scientists, and data scientists to support integrated, multidisciplinary analysis.</li><li>Assist in translating survey findings into analytic features, metrics, or summary outputs.</li><li>Work with analytics and software teams to ensure survey data and outputs are appropriately reflected in&nbsp;dashboards, reports, and user-facing tools.</li><li>Support validation and review of analytic products that incorporate survey-based measures.</li><li>Ensure appropriate context and limitations are communicated alongside survey results.</li><li>Contribute to documentation of survey methods, assumptions, limitations, and appropriate interpretation.</li><li>Support preparation of summaries, briefings, and written materials communicating survey findings to Government stakeholders.</li><li>Ensure survey-related content aligns with approved terminology and messaging.</li></ul><h4>Qualifications</h4>Required Qualifications<ul><li>Master’s degree or PhD in Psychology, Behavioral Science, Human Factors, Social Science, or a related field.</li><li>Demonstrated experience designing, implementing, or analyzing&nbsp;survey-based research.</li><li>Strong understanding of research methods, psychometrics, and data interpretation.</li><li>Experience supporting applied research or analytics in government, military, or large organizational environments.</li><li>Ability to collaborate effectively with multidisciplinary teams spanning research, analytics, and software development.</li><li>Strong written and verbal communication skills.</li><li>Ability to obtain and maintain a&nbsp;Secret security clearance.</li></ul>Desired Qualifications<ul><li>Experience supporting behavioral or psychosocial research related to health, performance, readiness, or organizational effectiveness.</li><li>Familiarity with integrating survey data into analytics platforms or decision-support systems.</li><li>Experience working alongside data science or AI/ML teams.</li><li>Prior experience supporting&nbsp;DoW or federal customers.</li></ul>Location &amp; Travel<ul><li>Duty Location:&nbsp;This is an&nbsp;in-person position&nbsp;requiring daily on-site support at&nbsp;Fort Eustis, Virginia.</li><li>Travel:&nbsp;Limited travel outside Fort Eustis may be required in support of program coordination or stakeholder engagement.</li></ul>Target salary range:&nbsp;$90,000 - $155,000The salary range displayed represents the typical salary range for this position and is not a guarantee of compensation. Individual salaries are determined by various factors including, but not limited to location, internal equity, business considerations, client contract requirements, and candidate qualifications, such as education, experience, skills, and security clearances.<h4> LMI is an Equal Opportunity Employer. LMI is committed to the fair treatment of all and to our policy of providing applicants and employees with equal employment opportunities. LMI recruits, hires, trains, and promotes people without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, pregnancy, disability, age, protected veteran status, citizenship status, genetic information, or any other characteristic protected by applicable federal, state, or local law. If you are a person with a disability needing assistance with the application process, please contact <a href="mailto:accommodations@lmi.org" target="_blank">accommodations@lmi.org</a> Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information. Need help finding the right job? </h4>We can recommend jobs specifically for you!Click here to get started.

Research Psychologist (Suvey SME) - Clearance Required

Salary Range:&nbsp;&nbsp;$171,925.00&nbsp;(Min.) -&nbsp;$232,100.00&nbsp;(Mid.) -&nbsp;$292,274.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Senior Director of Strategic Investments and Partnerships leads L.A. Care’s strategic giving, investments, innovation, and partnership work with the Chief Strategy and Transformation Officer.&nbsp; This position will manage and research investment trends in strategic giving and broader investments that support L.A. Care’s business. In tandem with the strategic plan, this position will ensure that annually investments and partnerships are aligned with strategic priorities. The position will work in tandem with the analytics team on artificial intelligence (AI), emerging technologies and innovation opportunities. The Senior Director is responsible for charting LA Care’s path in strategic investments, external partnerships, and impactful community giving in collaboration with internal departments who design and operationalize community programs and initiatives. This position serves as a crucial bridge between organizational strategy and external collaboration, ensuring that capital and community resources are deployed to further the health plan’s mission, maximize value, and foster health equity across Los Angeles County. With oversight of a multi-million-dollar portfolio, the Senior director works with internal operational teams to leverage both quantitative and qualitative insights to unlock new avenues for innovation, growth, and social impact, and build relationships with community leaders, business partners, philanthropic organizations and other key stakeholders in Los Angeles County and beyond to enhance L.A. Care’s influence and reputation.The Senior Director leads LA Care’s advancement into innovative digital health solutions, focusing on the adoption and integration of artificial intelligence and other disruptive technologies alignment investment and partnership opportunities with this work. This leader crafts a forward-thinking technology vision to propel L.A. Care’s service delivery, member engagement, and operational efficiency. Acting as both strategist, persuader, and champion, the role evaluates next-generation tools, fosters experimentation, and ensures responsible implementation that meets legal and ethical standards—positioning L.A. Care as a tech-enabled health plan prepared for the future of healthcare.The Senior Director will direct all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.&nbsp; The Senior Director will coordinate, consult and coordinate across L.A. Care to ensure that business partners are engaged to ensure the point of view of the business is key in investments and partnerships.<h4>Duties</h4>Develops and refines the organization’s strategic investment portfolio and partnership roadmap.&nbsp; Guides the direction and effectiveness of community giving programs to support core L.A. Care objectives.&nbsp; Aligns investment and partnership efforts with long-term organizational growth and innovation goals. Oversees due diligence, selection, and management of investment and partnership opportunities across L.A. Care with relevant stakeholders. &nbsp;Works with internal operational and programmatic leaders to ensure operationalization of investment and giving programs, including budget oversight and performance tracking.Monitors program outcomes, reports to executive leadership, and recommends course corrections as needed.Builds, mentors, and retains a high-performing team accountable for program results.Fosters a culture of mission-driven engagement, collaboration, and professional growth.Sets clear goals, coach direct reports, and ensure cross-team accountability.Creatively thinks and responds to emerging threats and issues and examines business opportunities and needs in respond.Develops and executes community-based initiatives and advocacy in partnership with operational and program leaders.Collaborates on investment planning, budget management, ROI analyses and accounting for investments and community giving.<h4>Duties Continued</h4>Coordinates community supports cross-functional stakeholders within the organization to obtain input on strategic investments and partnerships from the organization's stakeholders including but not limited to the Public Advisory Committees. Supports senior leadership and the Board in the development of strategic investments and partnerships to grow and develop the business and serve the community of Los Angeles County. Develops goals, objectives and actions plans for assigned staff which includes full management responsibility for the hiring, performance reviews, salary reviews and disciplinary matters for direct reporting employees. Prepares briefings, reports, consultation documents and presentations that clearly articulate L.A. Care's regulatory position and policy. Develops regulatory position and policy based on research and evidence.Develop, and manage department budget, monitor expenditures and ensures financial sustainability.Shapes digital innovation strategy, prioritizing high-impact tech investments for LA Care.Serves as a thought leader on emerging tech, guiding adoption in clinical and administrative domains.Anticipates industry trends and regulatory shifts to maintain competitive edge.<h4>Performs other duties as assigned. </h4><h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Public Health or Related Field<h4>Experience</h4>Required:At least 9 years of relevant experience in a health organization or managed care setting with government health programs, health policy, social service organizations and/or government.At least 8 years leading staff or supervisory/management experience in a health organization or managed care setting, focusing on government health programs, health policies, social service organizations, etc. <h4>Skills</h4>Required:Ability to perform both qualitative and quantitative analysis and research. Excellent analytical, communication and strategic planning skills and a demonstrated ability to build strategic alliances are key.Ability to make timely and effective decisions.Strong ability to prioritize and handle multiple initiatives in parallel as well as changing priorities.Excellent organizational, technical writing, verbal and interpersonal communication skills, and keen attention to detail.Excellent interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment.Strong strategic and operational acumen, with the ability to collaborate across business areas, anticipate analytic needs, and ensure alignment with enterprise priorities and transformation initiatives. Demonstrated ability to adapt to a fast-paced and evolving environment.Excellent verbal and written communication skills.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Philanthropic, Philanthropy, Public Health, Equity, Nonprofit, Healthcare, Finance

L.A. Care Health Plan

Senior Director, Strategic Investments, Innovation and Partnerships

Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Enterprise Data Analyst III serves as a Subject Matter Expert (SME) contributor responsible for leading complex analytic projects that link insights directly to enterprise goals, resource allocation, and performance improvement. This position leads the full analytic development process from business case definition and structured scoping through peer review, deployment, and post-implementation evaluation, ensuring high-quality, reproducible, and impactful outputs.The Analyst III applies advanced analytic reasoning and strong business acumen to deliver analyses that inform both operational and financial decision making. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.&nbsp; <h4>Duties</h4>Leads end-to-end analytic development, from structured business case definition and requirements gathering to delivery of validated, actionable insights.Conducts advanced analyses evaluating drivers of quality, operational efficiency, and financial performance.Coordinates with IT and product owners to ensure analytic outputs are integrated into enterprise systems and recurring workflows.Develops, optimizes, and automates analytic assets (data models, dashboards, reports) following enterprise design and refresh standards.Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases.Maintains awareness of data lineage and governance compliance throughout all analytic work.Manages project planning, tracking, and post-implementation assessment for assigned deliverables.Mentors and models adherence to analytic development best practices.Applies subject matter expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.Perform other duties as assigned.<h4>Duties Continued</h4>Domain Specific Experience and Skills:Domain Focus: Authorization &amp; Claims Operations AnalyticsRequired: Experience with Utilization Management (UM) authorization workflows and prior authorization metrics. Knowledge of claims operations, including receiving, adjudication, and provider dispute resolution. Knowledge of clinical and financial aspects of UM/claims and collaboration with operations or provider teams. Ability to analyze operational Key Performance Indicators (KPIs) (e.g., turnaround times, denial rates, appeals outcomes) and translate data into actionable insights.Domain Focus: Network Strategy AnalyticsRequired: Experience supporting initiatives to optimize cost, access, and quality within provider networks. Experience analyzing provider networks, including contracting, credentialing, and panel optimization. Ability to evaluate network performance metrics and translate findings into actionable insights for strategy and business planning.Domain Focus: Risk Adjustment AnalyticsRequired: Experience with risk adjustment methodologies, including Hierarchical Condition Category (HCC) coding, hierarchical models, and member risk scoring. Knowledge of diagnosis documentation, encounter data, and coding completeness to optimize plan revenue and quality scores. Knowledge of regulatory requirements impacting risk adjustment (e.g., Centers for Medicare and Medicaid Services (CMS) guidelines). Ability to assess encounter submission and processing operations, identifying trends, anomalies, or gaps in risk capture across provider or member populations.Preferred Certification: AAPC Certified Risk Adjustment Coder (CRC®); Practice Management Institute Certified Risk Adjustment and HCC Coder (CRA-HCC™); NAMAS Certified HCC Coder (CHCC™); AHIMA Certified Coding Specialist (CCS®)Domain Focus: Medical Cost Driver AnalyticsRequired: Experience analyzing medical cost drivers across populations, conditions, and service types. Experience developing dashboards or analytic tools to monitor and optimize medical spend. Knowledge of claims, provider, and condition level analyses to support financial and operational decision making. Ability to identify high-cost services, utilization patterns, and opportunities for cost containment.<h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree<h4>Experience</h4>Required:At least 4 years of experience in analytics, with substantial exposure to healthcare operations, managed care, or population health.Experience leading end-to-end analytic projects, including requirements gathering, data validation, analysis, and delivery of insights.Experience analyzing multiple data sources and translate findings into actionable recommendations.Preferred:Experience with advanced analytics techniques, including multivariate analysis, regression, control charts, or predictive modeling.Experience in domain specific operations, such as network strategy, risk adjustment, or medical cost driver analysis.Experience mentoring junior analysts or providing guidance on analytic best practices.<h4>Skills</h4>RequiredExpert in SQL for complex exploratory analysis, data modeling, and Extract, Transform, and Load (ETL) processes supporting enterprise dashboards, reports, and analytic deliverables.&nbsp;Advanced proficiency in Tableau (or equivalent BI tools) to design, optimize, and automate dashboards and visualizations for enterprise level insights.Strong statistical and analytical skills, including multivariate analyses, regression, and control charts to identify drivers of operational, clinical, and financial performance.Knowledge of version control (Git, GitHub) and collaborative development workflows, including peer review, continuous integration, and reproducible analytic practices.Ability to develop and maintain reusable analytic frameworks, templates, and processes that support recurring reporting and performance monitoring.&nbsp;Proficiency in data validation, reconciliation, and adherence to governance standards, including data lineage tracking and quality control.Ability to translate complex business problems into structured analytic requirements and actionable insights.&nbsp;Ability to interpret analytic results in the context of organizational performance, operational priorities, and enterprise goals.&nbsp;Ability to apply critical thinking to identify patterns, opportunities, and risks across multiple data domains.&nbsp;Ability to collaborate effectively with IT, operational teams, and business partners to operationalize analytic outputs.&nbsp;Demonstrated knowledge of healthcare concepts, such as quality measures, utilization patterns, and key operational drivers in a managed care environment.Ability to lead analytic projects end-to-end, including business case definition, requirements gathering, analysis, and post-implementation assessment.&nbsp;Ability to mentor junior analysts and promote adherence to analytic best practices.&nbsp;Ability to manage multiple projects simultaneously, prioritize tasks, and escalate issues appropriately.&nbsp;Ability to communicate findings effectively to both technical and non-technical stakeholders.&nbsp;<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Tableau Certified Data Analyst or Tableau Desktop SpecialistMicrosoft Certified: Power BI Data Analyst AssociateSnowflake SnowPro Core CertificationSnowPro® Specialty: Snowpark CertificationSQL Certification (e.g., DataCamp SQL Associate Certificate, Codecademy SQL Professional Certification, W3Schools SQL Certification)Certified Health Data Analyst (CHDA)Managed Care Professional (MCP) or relevant certification.<h4>Required Training</h4>General Skills Preferred:Proficient with Process Improvement Methodology including defining and documenting workflow.&nbsp;Knowledge of program and project level planning, mobilization and managementDomain Specific Experience and Skills: Domain Focus: Population Health AnalyticsRequired: Experience analyzing community supports, care management, health education, Managed Long-Term Support Services (MLTSS), and intervention programs. Experience translating data into actionable insights to guide interventions, resource allocation, program improvements, and new ideas for member programs based on population needs. Knowledge of population health management frameworks and social determinants of health. Ability to evaluate population level outcomes and operational performance metrics. Preferred: Experience understanding and responding to ongoing California Department of Health Care Services (DHCS) requirements for various programs, such as CalAIM. Domain Focus: Quality Improvement AnalyticsRequired: Experience analyzing Healthcare Effectiveness Data and Information Set (HEDIS), Stars, and other quality measurement programs across both medical and pharmacy domains. Experience translating data into actionable insights to inform interventions, compliance, and performance improvement strategies. Knowledge of quality measurement frameworks, regulatory requirements, and reporting standards. Ability to evaluate performance metrics, trends, and gaps to support quality improvement initiatives.Preferred: Experience supporting quality reporting requirements and initiatives for regulatory or accreditation programs (e.g., CMS, DHCS).Experience supporting provider focused incentive program analytics. Preferred Certification: Certified Professional in Healthcare Quality (CPHQ)<h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Domain Specific Experience and Skills:Domain Focus: Access to Care AnalyticsRequired: Experience analyzing appointment timeliness, access, and provider availability. Experience translating data into actionable insights to improve access, reduce barriers, and optimize provider scheduling. Experience supporting initiatives to improve network adequacy and member access, including operational interventions and performance monitoring. Knowledge access measurement frameworks and regulatory requirements. Ability to evaluate member access metrics, network capacity, and operational performance. Domain Focus: Enterprise Support AnalyticsRequired: Experience supporting enterprise level KPI maintenance, cross domain dashboards, and measure ROI analyses. Ability to develop analytic tools and dashboards that consolidate insights across multiple domains. Experience translating data into actionable insights for strategic investments, operational decisions, and organizational performance monitoring. Knowledge of analytics frameworks, governance standards, and enterprise reporting processes.Preferred: Experience supporting talent development analytics or enterprise-wide strategic initiative evaluation.Domain Focus: Member Experience AnalyticsRequired: Experience analyzing call center operations, enrollment services, and appeals &amp; grievances. Experience translating data into actionable insights to improve member experience and member engagement operations. Knowledge of Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys or other member satisfaction measurement tools. Ability to assess member touchpoints, satisfaction metrics, and operational KPIs.Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Claims, Medicaid, Medical Coding, Medicare, Pharmacy, Insurance, Healthcare

Enterprise Data Analyst III

Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Enterprise Data Analyst III serves as a Subject Matter Expert (SME) contributor responsible for leading complex analytic projects that link insights directly to enterprise goals, resource allocation, and performance improvement. This position leads the full analytic development process from business case definition and structured scoping through peer review, deployment, and post-implementation evaluation, ensuring high-quality, reproducible, and impactful outputs.The Analyst III applies advanced analytic reasoning and strong business acumen to deliver analyses that inform both operational and financial decision making. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.&nbsp; <h4>Duties</h4>Leads end-to-end analytic development, from structured business case definition and requirements gathering to delivery of validated, actionable insights.Conducts advanced analyses evaluating drivers of quality, operational efficiency, and financial performance.Coordinates with IT and product owners to ensure analytic outputs are integrated into enterprise systems and recurring workflows.Develops, optimizes, and automates analytic assets (data models, dashboards, reports) following enterprise design and refresh standards.Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases.Maintains awareness of data lineage and governance compliance throughout all analytic work.Manages project planning, tracking, and post-implementation assessment for assigned deliverables.Mentors and models adherence to analytic development best practices.Applies subject matter expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.Perform other duties as assigned.<h4>Duties Continued</h4>Domain Specific Experience and Skills:Domain Focus: Authorization &amp; Claims Operations AnalyticsRequired: Experience with Utilization Management (UM) authorization workflows and prior authorization metrics. Knowledge of claims operations, including receiving, adjudication, and provider dispute resolution. Knowledge of clinical and financial aspects of UM/claims and collaboration with operations or provider teams. Ability to analyze operational Key Performance Indicators (KPIs) (e.g., turnaround times, denial rates, appeals outcomes) and translate data into actionable insights.Domain Focus: Network Strategy AnalyticsRequired: Experience supporting initiatives to optimize cost, access, and quality within provider networks. Experience analyzing provider networks, including contracting, credentialing, and panel optimization. Ability to evaluate network performance metrics and translate findings into actionable insights for strategy and business planning.Domain Focus: Risk Adjustment AnalyticsRequired: Experience with risk adjustment methodologies, including Hierarchical Condition Category (HCC) coding, hierarchical models, and member risk scoring. Knowledge of diagnosis documentation, encounter data, and coding completeness to optimize plan revenue and quality scores. Knowledge of regulatory requirements impacting risk adjustment (e.g., Centers for Medicare and Medicaid Services (CMS) guidelines). Ability to assess encounter submission and processing operations, identifying trends, anomalies, or gaps in risk capture across provider or member populations.Preferred Certification: AAPC Certified Risk Adjustment Coder (CRC®); Practice Management Institute Certified Risk Adjustment and HCC Coder (CRA-HCC™); NAMAS Certified HCC Coder (CHCC™); AHIMA Certified Coding Specialist (CCS®)Domain Focus: Medical Cost Driver AnalyticsRequired: Experience analyzing medical cost drivers across populations, conditions, and service types. Experience developing dashboards or analytic tools to monitor and optimize medical spend. Knowledge of claims, provider, and condition level analyses to support financial and operational decision making. Ability to identify high-cost services, utilization patterns, and opportunities for cost containment.<h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree<h4>Experience</h4>Required:At least 4 years of experience in analytics, with substantial exposure to healthcare operations, managed care, or population health.Experience leading end-to-end analytic projects, including requirements gathering, data validation, analysis, and delivery of insights.Experience analyzing multiple data sources and translate findings into actionable recommendations.Preferred:Experience with advanced analytics techniques, including multivariate analysis, regression, control charts, or predictive modeling.Experience in domain specific operations, such as network strategy, risk adjustment, or medical cost driver analysis.Experience mentoring junior analysts or providing guidance on analytic best practices.<h4>Skills</h4>RequiredExpert in SQL for complex exploratory analysis, data modeling, and Extract, Transform, and Load (ETL) processes supporting enterprise dashboards, reports, and analytic deliverables.&nbsp;Advanced proficiency in Tableau (or equivalent BI tools) to design, optimize, and automate dashboards and visualizations for enterprise level insights.Strong statistical and analytical skills, including multivariate analyses, regression, and control charts to identify drivers of operational, clinical, and financial performance.Knowledge of version control (Git, GitHub) and collaborative development workflows, including peer review, continuous integration, and reproducible analytic practices.Ability to develop and maintain reusable analytic frameworks, templates, and processes that support recurring reporting and performance monitoring.&nbsp;Proficiency in data validation, reconciliation, and adherence to governance standards, including data lineage tracking and quality control.Ability to translate complex business problems into structured analytic requirements and actionable insights.&nbsp;Ability to interpret analytic results in the context of organizational performance, operational priorities, and enterprise goals.&nbsp;Ability to apply critical thinking to identify patterns, opportunities, and risks across multiple data domains.&nbsp;Ability to collaborate effectively with IT, operational teams, and business partners to operationalize analytic outputs.&nbsp;Demonstrated knowledge of healthcare concepts, such as quality measures, utilization patterns, and key operational drivers in a managed care environment.Ability to lead analytic projects end-to-end, including business case definition, requirements gathering, analysis, and post-implementation assessment.&nbsp;Ability to mentor junior analysts and promote adherence to analytic best practices.&nbsp;Ability to manage multiple projects simultaneously, prioritize tasks, and escalate issues appropriately.&nbsp;Ability to communicate findings effectively to both technical and non-technical stakeholders.&nbsp;<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Tableau Certified Data Analyst or Tableau Desktop SpecialistMicrosoft Certified: Power BI Data Analyst AssociateSnowflake SnowPro Core CertificationSnowPro® Specialty: Snowpark CertificationSQL Certification (e.g., DataCamp SQL Associate Certificate, Codecademy SQL Professional Certification, W3Schools SQL Certification)Certified Health Data Analyst (CHDA)Managed Care Professional (MCP) or relevant certification.<h4>Required Training</h4>General Skills Preferred:Proficient with Process Improvement Methodology including defining and documenting workflow.&nbsp;Knowledge of program and project level planning, mobilization and managementDomain Specific Experience and Skills: Domain Focus: Population Health AnalyticsRequired: Experience analyzing community supports, care management, health education, Managed Long-Term Support Services (MLTSS), and intervention programs. Experience translating data into actionable insights to guide interventions, resource allocation, program improvements, and new ideas for member programs based on population needs. Knowledge of population health management frameworks and social determinants of health. Ability to evaluate population level outcomes and operational performance metrics. Preferred: Experience understanding and responding to ongoing California Department of Health Care Services (DHCS) requirements for various programs, such as CalAIM. Domain Focus: Quality Improvement AnalyticsRequired: Experience analyzing Healthcare Effectiveness Data and Information Set (HEDIS), Stars, and other quality measurement programs across both medical and pharmacy domains. Experience translating data into actionable insights to inform interventions, compliance, and performance improvement strategies. Knowledge of quality measurement frameworks, regulatory requirements, and reporting standards. Ability to evaluate performance metrics, trends, and gaps to support quality improvement initiatives.Preferred: Experience supporting quality reporting requirements and initiatives for regulatory or accreditation programs (e.g., CMS, DHCS).Experience supporting provider focused incentive program analytics. Preferred Certification: Certified Professional in Healthcare Quality (CPHQ)<h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Domain Specific Experience and Skills:Domain Focus: Access to Care AnalyticsRequired: Experience analyzing appointment timeliness, access, and provider availability. Experience translating data into actionable insights to improve access, reduce barriers, and optimize provider scheduling. Experience supporting initiatives to improve network adequacy and member access, including operational interventions and performance monitoring. Knowledge access measurement frameworks and regulatory requirements. Ability to evaluate member access metrics, network capacity, and operational performance. Domain Focus: Enterprise Support AnalyticsRequired: Experience supporting enterprise level KPI maintenance, cross domain dashboards, and measure ROI analyses. Ability to develop analytic tools and dashboards that consolidate insights across multiple domains. Experience translating data into actionable insights for strategic investments, operational decisions, and organizational performance monitoring. Knowledge of analytics frameworks, governance standards, and enterprise reporting processes.Preferred: Experience supporting talent development analytics or enterprise-wide strategic initiative evaluation.Domain Focus: Member Experience AnalyticsRequired: Experience analyzing call center operations, enrollment services, and appeals &amp; grievances. Experience translating data into actionable insights to improve member experience and member engagement operations. Knowledge of Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys or other member satisfaction measurement tools. Ability to assess member touchpoints, satisfaction metrics, and operational KPIs.Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Claims, Medicaid, Medical Coding, Pharmacy, Call Center, Insurance, Healthcare, Customer Service

Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Enterprise Data Analyst III serves as a Subject Matter Expert (SME) contributor responsible for leading complex analytic projects that link insights directly to enterprise goals, resource allocation, and performance improvement. This position leads the full analytic development process from business case definition and structured scoping through peer review, deployment, and post-implementation evaluation, ensuring high-quality, reproducible, and impactful outputs.The Analyst III applies advanced analytic reasoning and strong business acumen to deliver analyses that inform both operational and financial decision making. Acts as a Subject Matter Expert (SME), serves as a resource and mentor for other staff.&nbsp; <h4>Duties</h4>Leads end-to-end analytic development, from structured business case definition and requirements gathering to delivery of validated, actionable insights.Conducts advanced analyses evaluating drivers of quality, operational efficiency, and financial performance.Coordinates with IT and product owners to ensure analytic outputs are integrated into enterprise systems and recurring workflows.Develops, optimizes, and automates analytic assets (data models, dashboards, reports) following enterprise design and refresh standards.Implements and maintains version control, peer review (pull request), and continuous integration practices for analytic codebases.Maintains awareness of data lineage and governance compliance throughout all analytic work.Manages project planning, tracking, and post-implementation assessment for assigned deliverables.Mentors and models adherence to analytic development best practices.Applies subject matter expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.Perform other duties as assigned.<h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree<h4>Experience</h4>Required:At least 4 years of experience in analytics, with substantial exposure to healthcare operations, managed care, or population health.Experience leading end-to-end analytic projects, including requirements gathering, data validation, analysis, and delivery of insights.Experience analyzing multiple data sources and translate findings into actionable recommendations.Preferred:Experience with advanced analytics techniques, including multivariate analysis, regression, control charts, or predictive modeling.Experience in domain specific operations, such as network strategy, risk adjustment, or medical cost driver analysis.Experience mentoring junior analysts or providing guidance on analytic best practices.Proficient with Process Improvement Methodology including defining and documenting workflow.&nbsp;Knowledge of program and project level planning, mobilization and management<h4>Skills</h4>RequiredExpert in SQL for complex exploratory analysis, data modeling, and Extract, Transform, and Load (ETL) processes supporting enterprise dashboards, reports, and analytic deliverables.&nbsp;Advanced proficiency in Tableau (or equivalent BI tools) to design, optimize, and automate dashboards and visualizations for enterprise level insights.Strong statistical and analytical skills, including multivariate analyses, regression, and control charts to identify drivers of operational, clinical, and financial performance.Knowledge of version control (Git, GitHub) and collaborative development workflows, including peer review, continuous integration, and reproducible analytic practices.Ability to develop and maintain reusable analytic frameworks, templates, and processes that support recurring reporting and performance monitoring.&nbsp;Proficiency in data validation, reconciliation, and adherence to governance standards, including data lineage tracking and quality control.Ability to translate complex business problems into structured analytic requirements and actionable insights.&nbsp;Ability to interpret analytic results in the context of organizational performance, operational priorities, and enterprise goals.&nbsp;Ability to apply critical thinking to identify patterns, opportunities, and risks across multiple data domains.&nbsp;Ability to collaborate effectively with IT, operational teams, and business partners to operationalize analytic outputs.&nbsp;Demonstrated knowledge of healthcare concepts, such as quality measures, utilization patterns, and key operational drivers in a managed care environment.Ability to lead analytic projects end-to-end, including business case definition, requirements gathering, analysis, and post-implementation assessment.&nbsp;Ability to mentor junior analysts and promote adherence to analytic best practices. Ability to manage multiple projects simultaneously, prioritize tasks, and escalate issues appropriately. Ability to communicate findings effectively to both technical and non-technical stakeholders.&nbsp;<h4>Domain Specifics</h4>Domain Specific Experience and Skills:Domain Focus: Authorization &amp; Claims Operations AnalyticsRequired: Experience with Utilization Management (UM) authorization workflows and prior authorization metrics. Knowledge of claims operations, including receiving, adjudication, and provider dispute resolution. Knowledge of clinical and financial aspects of UM/claims and collaboration with operations or provider teams. Ability to analyze operational Key Performance Indicators (KPIs) (e.g., turnaround times, denial rates, appeals outcomes) and translate data into actionable insights.Domain Focus: Network Strategy AnalyticsRequired: Experience supporting initiatives to optimize cost, access, and quality within provider networks. Experience analyzing provider networks, including contracting, credentialing, and panel optimization. Ability to evaluate network performance metrics and translate findings into actionable insights for strategy and business planning.Domain Focus: Risk Adjustment AnalyticsRequired: Experience with risk adjustment methodologies, including Hierarchical Condition Category (HCC) coding, hierarchical models, and member risk scoring. Knowledge of diagnosis documentation, encounter data, and coding completeness to optimize plan revenue and quality scores. Knowledge of regulatory requirements impacting risk adjustment (e.g., Centers for Medicare and Medicaid Services (CMS) guidelines). Ability to assess encounter submission and processing operations, identifying trends, anomalies, or gaps in risk capture across provider or member populations.Preferred Certification: AAPC Certified Risk Adjustment Coder (CRC®); Practice Management Institute Certified Risk Adjustment and HCC Coder (CRA-HCC™); NAMAS Certified HCC Coder (CHCC™); AHIMA Certified Coding Specialist (CCS®)Domain Focus: Medical Cost Driver AnalyticsRequired: Experience analyzing medical cost drivers across populations, conditions, and service types. Experience developing dashboards or analytic tools to monitor and optimize medical spend. Knowledge of claims, provider, and condition level analyses to support financial and operational decision making. Ability to identify high-cost services, utilization patterns, and opportunities for cost containment.<h4>Domain Specifics</h4>Domain Specific Experience and Skills: Domain Focus: Population Health AnalyticsRequired: Experience analyzing community supports, care management, health education, Managed Long-Term Support Services (MLTSS), and intervention programs. Experience translating data into actionable insights to guide interventions, resource allocation, program improvements, and new ideas for member programs based on population needs. Knowledge of population health management frameworks and social determinants of health. Ability to evaluate population level outcomes and operational performance metrics. Preferred: Experience understanding and responding to ongoing California Department of Health Care Services (DHCS) requirements for various programs, such as CalAIM. Domain Focus: Quality Improvement AnalyticsRequired: Experience analyzing Healthcare Effectiveness Data and Information Set (HEDIS), Stars, and other quality measurement programs across both medical and pharmacy domains. Experience translating data into actionable insights to inform interventions, compliance, and performance improvement strategies. Knowledge of quality measurement frameworks, regulatory requirements, and reporting standards. Ability to evaluate performance metrics, trends, and gaps to support quality improvement initiatives.Preferred: Experience supporting quality reporting requirements and initiatives for regulatory or accreditation programs (e.g., CMS, DHCS).Experience supporting provider focused incentive program analytics. Preferred Certification: Certified Professional in Healthcare Quality (CPHQ)<h4>Domain Specifics</h4>Domain Specific Experience and Skills:Domain Focus: Access to Care AnalyticsRequired: Experience analyzing appointment timeliness, access, and provider availability. Experience translating data into actionable insights to improve access, reduce barriers, and optimize provider scheduling. Experience supporting initiatives to improve network adequacy and member access, including operational interventions and performance monitoring. Knowledge access measurement frameworks and regulatory requirements. Ability to evaluate member access metrics, network capacity, and operational performance. Domain Focus: Enterprise Support AnalyticsRequired: Experience supporting enterprise level KPI maintenance, cross domain dashboards, and measure ROI analyses. Ability to develop analytic tools and dashboards that consolidate insights across multiple domains. Experience translating data into actionable insights for strategic investments, operational decisions, and organizational performance monitoring. Knowledge of analytics frameworks, governance standards, and enterprise reporting processes.Preferred: Experience supporting talent development analytics or enterprise-wide strategic initiative evaluation.Domain Focus: Member Experience AnalyticsRequired: Experience analyzing call center operations, enrollment services, and appeals &amp; grievances. Experience translating data into actionable insights to improve member experience and member engagement operations. Knowledge of Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys or other member satisfaction measurement tools. Ability to assess member touchpoints, satisfaction metrics, and operational KPIs.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Tableau Certified Data Analyst or Tableau Desktop SpecialistMicrosoft Certified: Power BI Data Analyst AssociateSnowflake SnowPro Core CertificationSnowPro® Specialty: Snowpark CertificationSQL Certification (e.g., DataCamp SQL Associate Certificate, Codecademy SQL Professional Certification, W3Schools SQL Certification)Certified Health Data Analyst (CHDA)Managed Care Professional (MCP) or relevant certification.<h4>Physical Requirements</h4>LightSalary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Claims, Medicaid, Medical Coding, Medicare, Pharmacy, Insurance, Healthcare

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