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<p><b>Salary Range:&nbsp;</b>&nbsp;$105,267.00&nbsp;(Min.) -&nbsp;$139,478.00&nbsp;(Mid.) -&nbsp;$173,689.00&nbsp;(Max.)</p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p>This position is responsible for providing oversight in all aspects of Structured Query Language (SQL) Server database system design, implementation, troubleshooting, and administration. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.</p><h4>Duties</h4><p>Oversee all aspects of SQL Server database system design, implementation, troubleshooting, and administration. Develop, install, maintain and monitor company databases in a high performance/high availability environment while supporting enterprise projects. Provide general database design, implementation and administration to assure highest reliability and availability of I.T. services. Manage the Data Synchronization of multiple databases between data centers using transaction replication. Maintain database backup/recovery procedures and disaster recovery database environment. Implement and support database software upgrade and patch management procedures. </p><p>Identify performance issues, deadlocks/contentions and resolve them. Generate traces, execution plans and SQL Profiling. Create and manage database constraints and indexes. Support Development Team and Business users with database operations including the development of complex SQL, tuning of DML and the creation of stored procedures. Proactive housekeeping/archiving and shrinking of databases and logs. Develop and support procedures for database security. </p><p>Develop processes, procedures and guidelines for troubleshooting database events and performing tasks. Provide tier 2 and 3 support for all corporate SQL Server database systems and services to meet or exceed service level agreements. </p><h4>Evaluate and seek solutions to production issues as well as new projects. Work closely with application developers and project managers in solving production issues. </h4><h4>Applies subject 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 project’s/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.</h4><h4>Perform other duties as assigned.</h4><h4>Duties Continued</h4><h4>Education Required</h4>Bachelor's Degree in Computer Science or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree<h4>Experience</h4><p><b>Required:</b><br>At least 5 years of extensive and broad based experience in the design, administration and support of SQL Server databases with in depth experience in SQL Server 2008 R2/2012.&nbsp;</p><p>Extensive experience writing T-SQL and stored procedures and query tuning on high transaction databases.&nbsp;</p><p>Experienced in SQL Server Integration Services (SSIS) and SQL Server Reporting Services (SSRS) and SQL Server Analysis Services (SSAS).&nbsp;</p><p>Experience in SQL Server clustering and HA technologies including Always On, mirroring, log shipping and transactional replication.&nbsp;</p><p><b>Preferred:</b><br>Experience in administering SharePoint and IIS Platforms is preferred.</p><h4>Skills</h4><p><strong>Required:</strong><br>Sound knowledge of RDBMS concepts, database architecture and SQL/T-SQL.&nbsp;</p><p>Ability to maintain detailed database related documentation.&nbsp;</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Housekeeping, Healthcare                                                    </p>

L.A. Care Health Plan

SQL Server Database Administrator III

<p><b>Salary Range:&nbsp;&nbsp;<b><b><b><b>$88,854.00</b></b></b></b>&nbsp;(Min.) -&nbsp;<b><b><b><b>$115,509.00</b></b></b></b>&nbsp;(Mid.) -&nbsp;<b><b><b><b>$142,166.00</b></b></b></b>&nbsp;(Max.)</b></p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p><br>The Care Management Specialist II utilizes clinical skills and training to perform essential functions of care management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines.</p><p>Manages a specified caseload across the entire continuum of programmatic levels including those within National Committee for Quality Assurance (NCQA) scope or otherwise Complex/Catastrophic cases, which are those with the severest acuities or care needs and requiring the highest clinical skills and judgement. &nbsp;Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and facilitating member access to care in a timely and cost-effective manner.&nbsp;</p><p>Collaborates and communicates with member, family, and interdisciplinary health team to promote wellness and member empowerment, while ensuring access to appropriate services across the healthcare continuum and maximizing member benefit: Serves as clinical advocate for members, active interdisciplinary team member, liaison with other departments and external health care team. Provides direction and assistance to Care Coordinators and to Community Health Workers (CHW) of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines. Uses claims processing and care management software to look up member information, document contacts, and track member progress.&nbsp;</p><h4>Duties</h4><p>Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider’s utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs.</p><p>Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric communication which includes the interdisciplinary team, providers and family or authorized representatives; reviewing member claims histories and identifies intervention opportunities through the professional standards of practice; contacting and interviewing members to conduct a baseline assessment, assess self-care ability, assess knowledge and adherence deficits; conducting comprehensive clinical assessments as indicated; developing a member centric plan of care. Maintains assigned care management caseload for with a focus on the most complex, highest-risk members particularly those with advanced chronic conditions, co-occurring mental and/or substance abuse and complex social issues (e.g. homelessness, domestic violence).&nbsp; </p><p>Collaborates with primary care physician and other treating professionals as appropriate. Authorizes initiation of care management services and specialized program services for members and specific populations, and develops interventions designed to meet member or population desired outcomes. Provides comprehensive education and resources to members about accessing services, in-network use, national guidelines for care, community resources, and self-management skills and strategies.</p><p>Employs engagement techniques to build relationships with members and their authorized representatives. Encourages participants to participate in their health care decisions and assists member with researching treatment options in order to communicate effectively with providers and to make informed decisions.</p><h4>Notifies Care Coordinators and CHWs of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines.</h4><h4>Performs field assessment and care coordination functions in community settings with members, such as at the L.A. Care Community Resource Centers, medical clinics, and member homes.</h4><h4>Duties Continued</h4><h4>Meets and assesses members at L.A. Care Community Resource Centers, as needed.</h4><h4>Provides effective care management for Individualized Care Plan summary and interventions during the Interdisciplinary Care Team meetings based on department guidelines.</h4><h4>Facilitates appropriate use of resources and coordinates necessary services to improve health status and impact the cost of care. Identifies member needs for and refers to appropriate internal and external programs, as appropriate.</h4><h4>Encourages member and family empowerment through education and use of reliable resources.</h4><h4>Monitors and evaluates member progress: evaluates member response to interventions and refines action plan to produce desired outcomes. Identifies complex care management issues and discusses possible solutions with management. Assesses effectiveness of care plan’s goals and interventions on a regular basis.</h4><h4>Uses claims and care management software to document interactions and interventions with members, vendors, and providers. Maintains case information in the member's clinical records to promote care coordination. </h4><h4>Provides ongoing direction and support to internal customers regarding Care Management programs, processes, and benefit coverage.</h4><h4>Responsible for staying current with best practices, identifying areas for personal growth opportunities and works with management to develop a plan for obtaining the necessary training.</h4><h4>Performs other duties as assigned.</h4><h4>Education Required</h4>Associate's Degree in Nursing for Registered NursesMaster's Degree in Social Work for Licensed Clinical Social Workers<h4>Education Preferred</h4>Bachelor's Degree in Nursing for Registered Nurses<h4>Experience</h4><p><br><strong>Required:</strong><br>Minimum of 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments. &nbsp;</p><p>Experience providing care management with complex/catastrophic conditions.</p><h4>Skills</h4><p><br><b>Required:</b><br>Current knowledge of clinical standards of care and disease processes.</p><p>Critical thinking skill.&nbsp;</p><p>Excellent customer service skills.</p><p>Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and implement the most effective member-centered interventions.</p><p>Ability to triage immediate member health and safety risks.</p><p>Ability to sensitively manage member or family responses associated with high acuity cases and support effective coping.</p><p>Strong verbal and written communications skills to consult effectively with interdisciplinary teams, coordinate care with members and their families, and other internal and external stakeholders. &nbsp;</p><p>Ability to use a personal computer, and knowledge of medical information systems.</p><p>Knowledge of and ability to comply with HIPAA compliance.</p><p>Ability to interview, assess and coordinate care. Ability to prioritize caseload.</p><p>Knowledge of community resources.</p><p>Knowledge of Medi-Cal and Medicare regulations.</p><p>Ability to work as a part of a diverse team and gain consensus and resolution of problems.</p><p><b>Preferred:</b><br>Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.</p><h4>Licenses/Certifications Required</h4>Registered Nurse (RN);current and unrestricted California License OR Licensed Clinical Social Worker; current and unrestricted California License.<h4>Licenses/Certifications Preferred</h4>Certified Case Manager (CCM)Accredited Case Manager (ACM) CertificationCase Management Nurse – Board Certified (CMGT-BC)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Required:&nbsp;</b><br>Travel to offsite locations for work.</p><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>This position is a limited duration position. The term of this position is a minimum one year and maximum of two years from the start date unless terminated earlier by either party. Limited duration positions are full-time positions and are eligible to receive full benefits.</p><p><br><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Call Center, Nursing, Registered Nurse, Social Worker, Travel Nurse, Customer Service, Healthcare, Service                                                    </p>

Care Management Specialist II, D-SNP Team (12 month Assignment)

<p><b>Salary Range:&nbsp;</b>&nbsp;$135,136.00&nbsp;(Min.) -&nbsp;$175,676.00&nbsp;(Mid.) -&nbsp;$216,218.00&nbsp;(Max.)</p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p>The Manager, Cyber Defense Operations Center (CDOC) is responsible for leading a team of CDOC Analysts and managing LAC's relationship with its Managed Security Service Provider (MSSP) and the CrowdStrike Falcon Complete Analysts. This position manages all aspects of running an efficient &nbsp;team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports.</p><p>The CDOC Manager directs the daily functions, processes, and operations of the CDOC, ensuring policies and procedures are followed and performance expectations are met. The position will oversee the CDOC team providing real-time, continuous Cybersecurity monitoring and triage, incident analysis, and coordination and response. The CDOC Manager will act as an escalation point for technical escalations, working closely with customers and internal teams when needed to ensure the highest level of customer satisfaction.</p><h4>Duties</h4><p>Manages staff , including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others.</p><p>Oversees security alerts and leads the team in identifying and responding to security threats.</p><p>Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. &nbsp;</p><p>Creates, reviews, and approves new procedural documentation. Conducts product evaluations of security technologies. Defines, implements, and improves system monitoring, policies, and procedures.</p><p>Develops and maintains procedures and workflows for CDOC management, including escalation and notification procedures.</p><p>Creates and documents standard operating procedures (SOP’s). &nbsp;Instills and reinforces industry best practices.</p><p>Develops and maintains metrics to measure the effectiveness of the CDOC. &nbsp;Reports metrics and trends to the Director of the Cyber Defense Operations Center and CISO.</p><p>Manages and provides technical guidance and consultation related to information security issues.</p><p>Reviews and approves information system changes.</p><p>Drives continuous improvement, partnering with internal IT team members to implement and improve new tools, capabilities, frameworks, and methodologies.</p><p>Acts as the technical expert in multiple domains to coordinate CDOC &nbsp;efforts during incident and breach responses. Collaborates with other Information Security (InfoSec) &nbsp;and Information Technology (I.T.) teams to ensure that relevant organization-wide data is processed by the CDOC.<br></p><h4>Duties Continued</h4><p>Coordinates the InfoSec on-call schedule and escalation procedures.</p><p>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.</p><p>Performs other duties as assigned.</p><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><p><b>Required:</b></p><p>At least 7 years of experience leading comparable information security or technology teams with at least 4-5 years of management/ supervisory experience.</p><p><b>Equivalency:</b>&nbsp; Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.</p><p>Operational experience configuring and managing a Security Information and Event Management (SIEM) platform.</p><p>Operational experience monitoring cloud computing (eg, AWS, Azure, etc.) and SaaS environments.</p><p>Experience with leading the response to crises, incidents, and investigations.</p><p>Operational experience managing in a regulated environment (eg, classified networks, healthcare, finance, banking, etc.).</p><p><b>Preferred:</b></p><p>Experience with Vulnerability Management toolsets.</p><h4>Skills</h4><p><b>Required:</b><br>Strong understanding of networking and communication protocols (such as TCP/IP, UDP, SSL/TLS, IPSEC, HTTP/S, etc.).</p><p>Exceptional operational rigor with extensive real-world experience in SOC methodologies and frameworks for I.T. operations (eg, Information Technology Infrastructure Library (ITIL), National Institute of Standards and Technology (NIST), etc.).</p><p>Demonstrated ability to manage complex projects in an effective manner</p><p>Must possess a strong service mindset</p><p>Ability to provide threat and vulnerability analysis security advisory services</p><p>Excellent verbal, written communication and presentation skills.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Certified Information Systems Security Professional (CISSP)Certified Information Security Manager (CISM)Certified Ethical Hacker (CEH)Certified Hacking Forensic Investigator (CHFI)GIAC Certified Detection Analyst (GCDA)Offensive Security Certified Professional (OSCP)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Defense, Government                                                    </p>

Manager, Cyber Defense Operations Center

<p><b>Salary Range:&nbsp;</b>&nbsp;$60,778.00&nbsp;(Min.) -&nbsp;$75,950.00&nbsp;(Mid.) -&nbsp;$91,166.00&nbsp;(Max.)</p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p>The Utilization Management (UM) Quality Reporting and Auditing Specialist I is responsible for dynamically working with the quality team and UM Leadership to support and ensure effective implementation of reporting and auditing work plans and projects on behalf of L.A. Care’s Utilization Management Quality Program by working collaboratively and independently on components of reporting and auditing projects as assigned.</p><h4>Duties</h4><p>Ensures successful completion of assigned quality projects related to reporting, auditing, preparation and execution of external and internal audits while working with UM department to support quality projects including improvement and auditing and monitoring functions. </p><p>Completes projects related to the UM departments Quality and Compliance/Regulatory/Accreditation projects and cross functional departments and teams. </p><p>Supports the UM department with routine reporting and auditing/quality activities and work plans especially related to quality, reporting, regulations, accreditation and compliance.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </p><p>Manages administrative activities related to reporting, compliance, and quality projects in the UM department. </p><p>Plans and organizes collaboratively and cross departmental meetings to problem solve, document issues and validate activities or reports. </p><p>In collaboration with leadership and trainers, provides education to staff based on results of audit findings, including but not limited to assisting with updating job aids and demonstration of compliant processes in group or individual meetings.</p><p>Applies knowledge of federal and state requirements/standards to ensure compliance for reporting and auditing.</p><h4>Performs other duties as assigned.</h4><h4>Duties Continued</h4><h4>Education Required</h4>Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Bachelor's Degree in Business Administration or Related Field<h4>Experience</h4><p><b>Required:</b></p><p>At least 2 years of experience in a healthcare quality or quality/compliance role. </p><p>Experience navigating a EMR/ system. </p><p>Experience in using analytical skills related to reporting and data processing.</p><h4>Skills</h4><p><b>Required:</b><br>Ability to work under pressure with multiple deadlines.&nbsp;</p><p>Excellent verbal and written communication skills. &nbsp;</p><p>Ability to develop reports and documents on an as-needed basis.&nbsp;</p><p>Strong Microsoft Excel knowledge and skills</p><p>Knowledge of location of federal and state requirements and standards especially related to reporting and auditing.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Audit, Finance                                                    </p>

Utilization Management Quality Reporting and Auditing Specialist I

<p><b>Salary Range:&nbsp;</b>&nbsp;$105,267.00&nbsp;(Min.) -&nbsp;$139,478.00&nbsp;(Mid.) -&nbsp;$173,689.00&nbsp;(Max.)</p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p>The ETL Data Integration Developer III is responsible for the operational support of Informatica environment including but not limited to automation, job scheduling, dependencies, monitoring and maintenance of Extract, Transform, and Load&nbsp;(ETL) mappings, mapplets, and documentation. This position manages, administers and works with ETL administration in addressing systems performance including on-going optimization and tuning of Informatica environment. This position develops reliable and complex ETL processes to support new development of the Enterprise Data Warehouse, Data Marts and other Business Intelligence projects. This position also assists the Data Warehouse team in completing current Data Warehouse initiative projects. This position also performs the duties to analyze and evaluate the data source and data targets required for the ETL mapping. Design, develop and implement complex ETL processes. This position also supports and participates in source data analysis, specifically as it relates to domain definitions. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.</p><h4>Duties</h4><p>Responsible for the operational support of Informatica environment including but not limited to automation, job scheduling, dependencies, monitoring, maintenance, patches, upgrades, security, and administration. </p><p>Administers systems performance including on-going optimization and tuning of Informatica environment. </p><p>Supports and enhances existing Informatica environment and develops new, complex ETL processes to support additional design, development and deployment of the Enterprise Data Warehouse, and Data Marts.</p><p>Assists data warehouse team in completing current data warehouse initiative projects.</p><p>Analyzes and evaluates data sources.</p><p>Designs and implements complex ETL processes.</p><p>Applies subject 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 project’s/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</p><p>Performs other duties as assigned.</p><h4>Duties Continued</h4><h4>Education Required</h4>Bachelor's Degree in Statistics or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Statistics<h4>Experience</h4><p><b>Required:</b><br>5 years of experience in Informatica ETL Developer role in Data Warehouse projects, Enterprise Data Warehouse, Online Analytical Processing (OLAP) and dimensional data modeling.</p><p>At least 3 years of proven development experience in design and development of ETL/Data Integration and Informatica Power Center Suite.</p><p>Experience with Erwin data modeling toolset.</p><p>Experience working in a PL-SQL environment.</p><p>Expert in database concepts, logical/physical design and development.</p><p>Strong experience and comprehensive proficiency with Informatica in an Oracle Data Warehouse/BI environment&nbsp;</p><p>Experience in documenting requirements and negotiating commitments&nbsp;</p><p>Strong project life cycle experience.&nbsp;</p><h4>Skills</h4><p><b>Required:</b><br>Strong database development skills including the ability to analyze, create and optimize complex SQL queries and stored procedures, working on relational databases especially Oracle &amp; MS SQL Server.</p><p>Proficient in data analysis and problem solving.</p><p>Possess excellent communication skills, both written and verbal.</p><p>Thorough knowledge of Systems Development Life Cycle (SDLC).</p><p>Must develop, foster and maintain an open, professional relationship with IT staff, management and business customers.</p><p>Excellent verbal and written communication skills.</p><p>Strong organizational and documentation skills.</p><p>Strong Understanding of DW/BI concepts.&nbsp;</p><p>Good knowledge of Software Development Lifecycle.</p><p>Understanding of development lifecycle methodology and ability to &nbsp;successfully deliver Informatica assignments.</p><p>Healthcare domain.</p><p>Proven ability to perform technology needs assessment and evaluate solution options.</p><p>The capability of performing interface analysis at the detail level.</p><p>A solid understanding of software development life cycle; and broad-based knowledge of application systems technologies.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                </p>

ETL Data Integration Developer III

<p><b>Salary Range:&nbsp;</b>&nbsp;$91,536.00&nbsp;(Min.) -&nbsp;$121,286.00&nbsp;(Mid.) -&nbsp;$151,034.00&nbsp;(Max.)</p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p>The Core Systems Configuration Analyst III is responsible for the more complex technical and analytical work related to the maintenance, update, etc. of the configuration of the L.A. Care Health Plan Core Systems applications, and databases (e.g., QNXT Migration Utility, Claims Workflow, Claims Test Pro, NetworX Pricer, etc.). This position serves as a subject matter expert who has the ability to proactively identify and independently rectify issues and opportunities for configuration improvements. As the subject matter expert, this position performs peer review and applies advanced skillset to ensure quality of the work product. This position collaborates closely with peers and management within the department as well as throughout and outside of the organization to troubleshoot and facilitate the maintenance and update of the most complex configuration of the various modules of our core systems, applications, and databases as well as facilitate end-to-end interdepartmental and enterprise projects. This position also provides well thought-out recommendations for vendor enhancement of the core products.</p><h4>Duties</h4><p>Manage complex benefit dictionaries, evidence of coverage tables, provider contractual obligations (including capitation and fee-for-service contracts), Division of Financial Responsibility (DoFR), etc. and related documentation. Serve as a subject matter expert for configuration change management testing and related best practices. Facilitate production controls and system configuration data codification.&nbsp;</p><p>Monitor and review systems edits, response time issues, etc. and conducting related advanced root cause analysis to identify issues and provide well thought-out recommendations for resolution. Identify and facilitate the implementation/enhancement of systems, process improvements, and best practices.&nbsp;</p><p>Interface and collaborate with peers within and outside of the department and the organization to support configuration management best practices, systems enhancement processes, management of the system configuration life cycle management project/program plans, tracking of configuration change operational issues and resolution.</p><p>Perform peer review for all levels of staff and apply advanced skillset to ensure quality of the work product.</p><p>Perform other duties as assigned.</p><h4>Duties Continued</h4><h4>Education Required</h4>Bachelor's Degree in Business Administration or Healthcare AdministrationIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Business Administration or Healthcare Administration<h4>Experience</h4><p><b>Required:</b></p><p>At least 5 years of experience in a Systems Configuration, Claims or other Operations department in a healthcare organization.</p><p>Advanced knowledge of and experience with interpreting and analyzing complex pricing mechanism and contractual terms with providers, delegated groups and related contractual scenarios.</p><p>Knowledge of and experience with utilizing SDLC and related change management methodologies, standards, and best practices.</p><p>Advanced knowledge of and experience with current Commercial, Medicare, and Medicaid rules and regulations and core systems code and data sets, etc.</p><p><b>Preferred:&nbsp; </b></p><p>At least 5 years of experience working with a California Medi-Cal managed care plan or commercial health plan, medical group, or management services organization.</p><h4>Skills</h4><p><b>Required:</b></p><p>Advanced understanding of managed care operations (including but not limited to, claims processing; provider contracting, network and data management; complex pricing mechanisms; etc.) and the systems that support these operations.</p><p>Knowledge of Systems Development Life Cycle (SDLC) procedures in planning the systems configuration.</p><p>Advanced understanding of the application of the Division of Financial Responsibility (DoFR) to claims processing.</p><p>Strong communication, analytical, organizational, and time management skills.</p><p>Able to manage projects and initiatives end-to-end. </p><p>Able to meet strict, tight deadlines with a high level of accuracy.</p><p>Able to prioritize multiple tasks.</p><p>Able to work collaboratively with various level of peers and management throughout the organization.</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Healthcare Administration, Claims, Medicaid, Medicare, Healthcare, Insurance                                                    </p>

Core Systems Configuration Analyst III

<p><b>Salary Range:&nbsp;</b>&nbsp;$47,840.00&nbsp;(Min.) -&nbsp;$57,062.00&nbsp;(Mid.) -&nbsp;$68,474.00&nbsp;(Max.)</p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p>The Community Resource Center (CRC) Specialist II supports in building relationships with members of the community, L.A. Care departments, and Blue Shield of California Promise Health Plan staff (under a collaborative partnership agreement), community based agencies, government agencies, and CRC vendors and instructors. The role supports community and provider communication and engagement initiatives to increase member traffic at a CRC and provides information to members of the community to physical and health education programs, classes and resources. Acts as a key partner to support the CRC marketing and promotional initiatives to meet operational needs. Follows workflows to refer members to receive services across L.A. Care departments that support a member's health care journey to promote positive health care outcomes. Helps connect members and community participants in understanding health care access issues, identifies resource needs based on social drivers resulting from member inquiries and health assessments, and refers to the appropriate source for subject matter assistance. Provides ongoing member assistance and follow-up in select cases. Works in partnership with L.A. Care health plan departments to provide customer service, social services support, care management, health education resources, behavioral health, member engagement marketing and communication, relies on line of business product knowledge and business insight. The CRCs serve anyone in the community in which they are located; and therefore, this role will provide support on referral processes to connect non-member cases to the appropriate external resources and collaborate with key stakeholders across L.A. Care in support of positive outcomes for members.</p><p>Supports the planning and development, implementation, and analysis of CRC services, programming, and vendor management. This role may support special projects following directions and instructions from a work plan, technical procedures, and relationship management ensuring successful implementation of CRC initiatives. </p><h4>Duties</h4><p><b>Day-to-Day Representation: (25%)</b><br>Supports the coordination of member-centric customer service to respond and resolve inquiries and questions and bridges members to appropriate resources. &nbsp;Provides guidance and support to inform, guide, and educate members, community residents, and other stakeholders regarding health education programs, benefit information, resources and support available at L.A. Care and partner health plan benefits, CRC resources to meet the member/visitor needs. Collaborates with team members to create resource guides and reference materials. &nbsp;Implements the appropriate approach to identify member or visitor resource needs in complex situations and takes action to link the member/visitor to the appropriate services, programs, or resources. Actively identifies gaps in CRC services, resources, and programs, delivers recommendations for new programs and proposes solutions for the implementation of new services. &nbsp;Participates in day-to-day work operations including opening and closing of the CRC, ordering and maintaining of office supplies, and inventory. Supports CRC vendors which deliver facility maintenance. Coordinates, maintains, and schedules CRC calendar and conference rooms, including management of appointments. Prepares conference/training rooms and assists with support services, as needed. Answers incoming calls in a timely and professional manner. &nbsp;</p><p><b>High-Touch Customer Focus: (25%)&nbsp;</b><br>Performs high quality in-person service and contributes to the extended-hour schedule of the CRC to support members and visitors that may need services outside of regular operating hours and days based on business needs. Implements child development activities and programs to support children development while parents and guardians attend a class or service appointment at the CRC. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</p><p><b>Cross-Collaboration: (20%)</b><br>Supports community initiatives maintaining good relationships within L.A. Care and Blue Shield Promise Health Plan, and with community stakeholders to promote access to health care programs, classes, and preventative services offered at the CRC. &nbsp;Provides information to other L.A. Care departments on services and activities that resonate with and engage members of the CRC community based on hands-on experience at the Center.</p><p><b>Outreach and Engagement: (15%)</b></p><p>Supports and nurtures relationships with key internal and external stakeholders; and, is an ambassador to promote CRC partnership brand recognition. &nbsp;Establishes relationships with key community stakeholders, informs management on community needs, and enters data to inform an integrated approach to outreach activities and targeted member engagement. &nbsp;Supports planning, development, implementation, and analysis, of member and community engagement activities to increase member traffic at the supports outreach and engagement activities to attract new L.A. Care and partner health plan members into the CRC to participate in services and programs. Provides feedback to bridge members of the community to physical and health education programs and classes which will enhance health outcomes and member experience. &nbsp;Supports communications and marketing efforts through multiple platforms to increase member traffic at assigned CRC.</p><h4>Duties Continued</h4><p><b>Implementing Strategic Initiatives: (15%)</b><br>Supports the implementation of special projects which include identifying the scope of work responsibilities, accountabilities, deliverables, key milestones, timelines, and specific tasks that &nbsp;must be completed in order to ensure project, initiatives, and events are successfully implemented within the required timeframe.<br>Supports in monitoring risks and provides recommendations for management to implement mitigation plans to keep initiatives on-track. &nbsp;Collaborates in the maintenance of consistent documentation of project deliverables, tracks and reports project status. &nbsp;&nbsp;</p><p>Performs other duties as assigned. (10%)</p><h4>Education Required</h4>Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Bachelor's Degree<h4>Experience</h4><p><b>Required:</b><br>At least 6 months of community work focused on health care, public health, or health education, OR at least 6 months of operations work experience, community events, leading projects, and supporting relationships with multiple stakeholders.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;<br>Experience with data entry and reporting processes.&nbsp;</p><p><b>Preferred:</b><br>Previous experience in child development activities. &nbsp;</p><h4>Skills</h4><p><b>Required:</b><br>Ability to communicate verbally and in writing.</p><p>Organizational skills.</p><p>Detail-oriented, collaborative and enthusiastic team player.&nbsp;</p><p>Ability to assist with inquiries and identify creative solutions to assist members and community stakeholders.</p><p>Ability to troubleshoot problem areas and support effective alternative solutions and provide optimal customer service for internal and external customers.</p><p>Action oriented attitude to take on new opportunities and rewarding challenges with a sense of urgency, high energy, and enthusiasm.</p><p>Ability to multi-task and meet competing deadlines while maintaining attention to detail and accuracy.</p><p>Ability to work independently or as part of a diverse team while applying business-insight as well as empathy towards members.</p><p>Initiative to act on anticipated business needs in the operational and customer service areas.<br><br>Ability to adapt quickly to a fast-changing environment.</p><p>Knowledge of MS Office including Outlook, Word, Excel, and PowerPoint</p><p>Excellent customer service skills.</p><p>Interpersonal skills, ability to read non-verbal cues and apply situational adaptability skills.</p><p>Ability to make sound decisions with incomplete information.</p><p><b>Preferred:</b><br>Experience with the Salesforce Customer Relationship Management (CRM) platform</p><p>Knowledge and understanding of the unique needs of the Medi-Cal beneficiary populations within a social service, healthcare, not-for-profit, or government setting.&nbsp;</p><p>Knowledge of public agencies, organizations, and other resources that support Community Resource Center visitors.</p><p>Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.</p><h4>Licenses/Certifications Required</h4>Cardiopulmonary Resuscitation (CPR) Certified within 120 days of hire.<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><p>Within 120 days of hire: Cardiopulmonary resuscitation (CPR) and California Mandated Reporter. </p><p>Management of Aggressive Behavior (MOAB), de-escalation techniques training, safe lifting practices training. Emergency Action Plan (EAP).</p><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Required:</b></p><p>Travel to offsite locations for work.</p><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><ul><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Paid Sick Leave</li></ul><p><br><strong>Job Segment: </strong>                    Behavioral Health, Relationship Manager, Public Health, Data Entry, Social Services, Healthcare, Customer Service, Administrative, Service                                                    </p>

Community Resource Center Specialist II (Temporary)

<p><b>Salary Range:&nbsp;</b>&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)</p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p><br>The Internal Auditor III prepares audit programs and conducts audit reviews of assigned areas, including performing various audit procedures and documents in findings in work papers in accordance with department standards. Identifies internal control weaknesses, develops audit recommendations and drafts written reports. Provides independent evaluations of operational and financial controls, policies, and procedures. Prepares audit report detailing findings and recommendations. Performs and coordinates follow-up audits to determine if management has taken action to mitigate risks identified. Participates in special reviews as necessary.Acts as a &nbsp;Subject Matter Expert, serves as a resource and mentor for other staff.&nbsp;</p><h4>Duties</h4><p>Develops audit programs and testing procedures relevant to risk and test objectives. Provides independent evaluations of operational and financial controls, regulatory compliance, policies, and procedures. Prepares work papers, observations and reports and related documents following department standards.</p><p>Prepares audit programs and conducts audit reviews of assigned areas, including performing various audit procedures and documenting findings on work papers. Obtains and reviews evidence ensuring audit conclusions are well-documented. </p><p>Identifies internal control weaknesses, non-adherence with regulatory requirements, develops audit recommendations and drafts written reports. Identifies and communicates issues raised, offering recommended solutions relevant to business and risk. Ensures audit conclusions are based on a complete understanding of the process, circumstances, and risk. </p><p>Performs and coordinates follow-up audits to determine if management has taken action to mitigate risks and findings identified.</p><p>Applies subject 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 project’s/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.</p><p>Participates in special reviews as necessary.</p><p>Performs other duties as assigned.</p><h4>Duties Continued</h4><h4>Education Required</h4>Bachelor's Degree in Accounting or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4><h4>Experience</h4><p><strong>Required:</strong><br>At least 5 years of public or private accounting or audit experience, preferably in health care or other highly regulated industry.</p><h4>Skills</h4><p><br><b>Required:</b><br>Knowledge of finance, accounting and control principles, including GAAP and GAAS.</p><p>Excellent MS Office skills, including in Word, Excel and PowerPoint.</p><p>Ability to observe and understand business processes ensuring processes are documented completely and accurately.</p><p>Ability to apply audit standards through practical application.</p><p>Proactive in researching business best practice concepts in order to apply as appropriate.</p><p>Solid listening skills and ability to identify gaps in logic – inquisitive.</p><p>Strong organization and follow up skills including the ability to handle competing priorities and meet all deadlines and commitments.</p><p>Possess an appropriate combination of technical expertise in fields such as auditing, finance, technology, operations, or investigations.</p><p>Ability to flourish in a fast-paced, complex environment and willing to adapt to change.</p><p>Ability to give and follow instructions accurately and efficiently; proactive in asking clarifying questions to ensure work effort is directed wholly toward desired outcome.</p><p>Ability to recognize when learned theoretical concepts should be applied.</p><p>Solid understanding and ability to apply risk and control concepts</p><p>Ability to identify underlying cause of an issue raised.</p><p>Good awareness of other departments in the company with risk, control, and governance responsibilities and what is necessary for successful tactical collaboration and information sharing.</p><p>Good communication skills along with good or developing negotiation skills.</p><p>Ability to identify sensitive issues and facilitate communications in a proactive manner to avoid surprises.</p><p>Willingness and ability to adapt to new circumstances, information, and challenges.</p><p>Executes effective and thorough application of all internal audit standards within assigned responsibility.</p><p><b>Preferred:</b><br>Knowledge of Sarbanes-Oxley and COSO guidelines and requirements.</p><p>Risk assessment practices.</p><h4>Licenses/Certifications Required</h4>Certified Public Account (CPA) or Certified Internal Auditor (CIA) or Cerfitified Fraud Examiner (CFE) or Certified Information Systems Auditor (CISA)<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Internal Audit, Risk Management, Accounting, CPA, Audit, Finance                                                    </p>

Senior Internal Auditor

<p><b>Salary Range:&nbsp;&nbsp;<b><b><b><b>$55,245.00</b></b></b></b>&nbsp;(Min.) -&nbsp;<b><b><b><b>$69,045.00</b></b></b></b>&nbsp;(Mid.) -&nbsp;<b><b><b><b>$82,867.00</b></b></b></b>&nbsp;(Max.)</b></p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p>The Care Management Community Health Worker II (CHW) is part of the care management team and is responsible for promoting members’ optimal health and well-being through active engagement and helping them navigate and access health services. The CHW supports providers and the care management team through an integrated approach to care management and community outreach. Through 1:1 in-home visits as well as group education and support, the CHW helps identify members’ barriers to care and their preferences, provides education and mentoring, connects them to resources, and advocates for the individual. &nbsp;</p><h4>Duties</h4><p><b>Cultural Mediation Among Individuals, Communities, and Health and Social Service Systems</b>: Educating individuals and communities about how to use health and social service systems (including understanding how systems operate).&nbsp; Educating systems about community perspectives and cultural norms. Building health literacy and cross-cultural communication. (10%)</p><p><b>Providing Culturally Appropriate Health Education and Information</b>: Conducting health promotion and disease prevention education in a manner that matches linguistic and cultural needs of members. Providing necessary information to understand and prevent diseases and to help members manage health conditions (including chronic disease). (10%)</p><p><b>Care Coordination, Case Management, and System Navigation</b>: Participating in care coordination and case management. Making referrals and providing follow-up. Coordinating transportation to services and helping address barriers to services. Documenting and tracking individual and population level data. Informing people and systems about community assets and challenges. (20%)</p><p><b>Providing Coaching and Social Support</b>: Providing individual support and coaching. Motivating and encouraging people to obtain care and other services. Supporting self-management of disease prevention and management of health conditions (including chronic disease). Planning and/or leading support and health education groups. (15%)</p><p><b>Advocating for Individuals and Communities</b>: Advocating for the needs and perspectives of communities. Connecting to resources and advocating for basic needs (e.g. food and housing). Conducting policy advocacy for their communities. (10%)</p><p><b>Building Individual and Community Capacity</b>: Building individual capacity. Building community capacity. Training and building individual capacity with peers and among CHW groups. (5%)</p><h4><b>Implementing Individual and Community Assessments</b>: Participating in design, implementation, and interpretation of individual-level assessments (e.g. Health Risk Assessments, medication reviews, home environmental and safety assessment). Participating in design, implementation, and interpretation of community-level assessments (e.g. windshield survey of community assets and challenges, community asset mapping). (10%)</h4><h4>Duties Continued</h4><h4><b>Conducting Outreach</b>: Case-finding/recruitment of individuals, families, and community groups to services and systems. Follow up on health and social service encounters with individuals, families, and community groups. Home visiting to provide education, assessment, and social support. Presenting at local agencies and community events. (5%)</h4><h4>Attending regular staff meetings, on-site monthly trainings and other meetings as requested.&nbsp; Managing assigned caseload. (5%)</h4><h4>Perform other duties as assigned. (10%)</h4><h4>Education Required</h4>High School Diploma/or High School Equivalency Certificate<h4>Education Preferred</h4><h4>Experience</h4><p><b>Required:</b></p><p>At least 1 year of experience as a health navigator, peer support worker, outreach work, or promotora or working in a community setting and providing health education for chronic conditions, or equivalent.</p><h4>Skills</h4><p><b>Required:</b></p><p>Knowledge of community resources in area of residence.</p><p>Comfortable working with diverse populations.</p><p>Exceptional ability to connect and engage with people.</p><p>Ability to work in various environments including 1:1 in member’s homes, clinical settings, and/ or shelters.</p><p>Excellent verbal and written communication skills.</p><p>Detail oriented, organized and possess time management skills.</p><p>Basic computer skills.</p><p><b>Preferred:</b><br>Motivational interviewing is desirable.</p><p>"Bilingual in one of LA Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese ".</p><h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Mental Health First Aide Certification<h4>Required Training</h4><p><b>Preferred:</b><br>Successful completion of a Community Health Worker formal training program from a college or other education institution.</p><p><br>Training in health education for chronic diseases, motivational interviewing is desirable.</p><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><br><b>Required:</b><br>Travel to offsite locations for work.</p><p>Able to work flexible job hours.</p><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p>This position is a limited duration position. The term of this position is a minimum one year and maximum of two years from the start date unless terminated earlier by either party. Limited duration positions are full-time positions and are eligible to receive full benefits.</p><p><br><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Public Health, Counseling, Medical, Healthcare                                                    </p>

Care Management Community Health Worker II (12 Month Contract)

<p><b>Salary Range:&nbsp;</b>&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)</p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p>The Specialty Health Plans Auditor III, Finance, is offering a $5,000 sign-on offer. This role is responsible for all aspects of planning, execution, reporting, and corrective action plans, monitoring of financial solvency for specialty health plans and vendors. This includes medical, vision, dental, behavioral health, transportation, and telehealth services providers. &nbsp;These audits are intended to ensure that L.A. Care delegates comply with applicable regulatory requirements and L.A. Care contractual agreements across all lines of business.</p><p>Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.</p><h4>Duties</h4><p>Performs financial audits and/or financial analyses for Specialty Health Plans on the quarterly and annual basis.</p><p>Performs financial analyses for L.A. Care vendors on the quarterly and annual basis.</p><p>Provides timely and accurate deliverables to ensure financial solvency compliance with regulatory and contractual requirements for plan partners, participating provider groups, capitated hospitals, specialty health plans, and vendors.</p><p>Collaborates in the creation and implementation of standardized audit workpaper and reporting templates.</p><p>Is cross trained on financial solvency reviews for Participating Physician Group (PPGs), PPs, and capitated hospitals.</p><h4>Reviews and updates annually the department’s Policies and Procedures (P&amp;Ps).&nbsp; Ensures that any new or updated Policy and Procedure is reviewed and approved by management prior to submission. </h4><h4>Supports the formalization of key internal processes and monitoring tools.</h4><h4>Accountable for the completion of requests from Legal Department, Delegation Oversight’s monitoring oversight and reporting.</h4><h4>Responsible for the overall communication and collaboration with interdepartmental personnel, leadership, specialty health plans, and vendors.</h4><h4>Collaborates on the design, implementation, and reporting of special projects.</h4><h4>Collaborates on the design and implementation of reports and tools for corrective action plan issuance and non-compliance notifications.</h4><h4>Collaborates on the assessment, communication, and implementation of regulatory requirements that may impact internal processes.</h4><h4>Duties Continued</h4><h4>Applies subject 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 project’s/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.</h4><p>Performs other duties as assigned.</p><h4>Education Required</h4>Bachelor's Degree in Accounting or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree<h4>Experience</h4><p><b>Required:</b></p><p>At least 4 years of experience in conducting financial audits.&nbsp; </p><p>At least 5 years of related experience in the managed health care industry.&nbsp; </p><h4>Skills</h4><p><b>Required:</b></p><p>Excellent analytical and critical thinking skills.</p><p>Action-oriented, self-starter, and excellent motivator.</p><p>Excellent verbal and written communication skills.</p><p>Able to prioritize assignments, and able to independently with minimum supervision. </p><p>Ability to interface professionally with both internal and external customers at all levels of the organization.</p><p>Proficiency in Microsoft Office (Excel, PowerPoint, and SharePoint).</p><h4>Licenses/Certifications Required</h4>And/Or any of the following Licenses/ Certifications:Certified Public Accountant (CPA)Certified Internal Auditor (CIA)Certified Fraud Examiner (CFE)Certified Management Accountant (CMA)<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Accounting, CPA, Internal Audit, Medical, Audit, Finance, Healthcare                                                    </p>

37 L.A. Care Health Plan Jobs