Job description
Association’s Mission:
California Primary Care Association’s (CPCA’s) mission is to lead and position community clinics, health centers and networks through advocacy, education, and services as key players in the health care delivery system to improve the health status of their communities.
Purpose of Position:
The Assistant Director of Managed Care provides strategic and technical support to health centers on managed care and Medicare, focusing on financial sustainability and effective participation in managed care and Medicare arrangements. This role leads initiatives, analyzes trends, and develops policy positions and educational resources to guide health centers through managed care contracting, billing, value-based payment models, and regulatory requirements. Collaboration with internal teams, external partners, and policymakers is key, as is expertise in managed care operations, health policy, and the Medi-Cal and Medicare systems.
Primary Responsibilities:
- General Managed Care Expertise
- Lead the development and execution of managed care and Medicare strategies to support health centers in maximizing contracts and transitioning to value-based payment.
- Serve as a subject matter expert on managed care policies, contracts, billing, clinic networks, Medicare, and performance improvement strategies
- Conduct research, analyze data, and prepare reports to support advocacy, training, and grant deliverables.
- Support grant development and management, including proposal writing and compliance with funder requirements.
- Education, Training, and Resource Development
- Develop and deliver technical assistance and training (e.g., webinars, workshops, toolkits, articles) on managed care and Medicare.
- Lead or support Peer Networks, Workgroups, and Task Forces, including content development and facilitation.
- Ensure all resources and training align with CPCA’s strategic plan, grant requirements, and policy agenda.
- Relationship Building and Partnership
- Build relationships with member health centers to assess needs and provide tailored support.
- Cultivate partnerships with managed care plans, agencies, and stakeholder groups; represent CPCA in advisory committees.
- Build and maintain relationships with funders across private, public, and philanthropic sectors.
- Advocacy
- Advocate for health centers by engaging with policymakers and responding to policy proposals.
- Collaborate with internal staff and external partners to analyze and respond to legislation, regulations, and policy guidance (e.g., All-Plan Letters).
Skills and Abilities Required:
- Strong knowledge of managed care contracting, billing, Medicare, provider networks, performance improvement strategies, and value-based care models.
- Advanced problem-solving, critical thinking, time management, and organizational skills with attention to detail.
- Proven ability to work independently, prioritize effectively, and meet deadlines in a fast-paced, collaborative environment.
- Excellent verbal and written communication, including proofreading.
- Maintains confidentiality and handles sensitive matters professionally.
- Strong interpersonal skills; collaborates effectively with staff, leadership, members, vendors, and partners.
- Proficient in Microsoft Office, virtual communication tools, and web-based platforms.
Additional Responsibilities:
- Represent CPCA and member health centers with professionalism in various local, state, and national forums.
- Attend and participate in required Association meetings and events.
- Travel for state, regional, and national meetings, training, and site visits by air and ground transportation.
- Report regularly to supervisor.
- Other duties as assigned.
Education and Experience:
CPCA evaluates candidates on all position-relevant skills and experience. If you’re excited about this role, but your experience does not align perfectly with every requirement, we encourage you to apply anyway.
- Required:
- Bachelor’s degree in business administration, public health, healthcare administration, or related field required. Relevant experience may be considered in lieu of degree requirement.
- Minimum of 5 years of experience in managed care contracting, Medicare, or related areas within healthcare organizations or with health plans.
- Preferred:
- Master’s degree.
- Experience with community health centers and their financing, member-driven associations, or non-profit organizations.
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Hearing and speaking to exchange information
- Operating a computer and other office productivity equipment
- Seeing to read a variety of materials
- Bending at the waist, kneeling, or crouching
- Sitting or standing for extended periods of time
- Lifting objects up to 30 pounds
- Close vision and ability to adjust focus
Work Environment:
- Noise level is generally moderate, but at times can be noisy
- Meetings conducted in a Zoom or office setting
- Indoor varying temperature
- Employee must have available transportation and be able to commute into office
Compensation : $95,482 - $101,099
Association Expectation:
Due to network security and hybrid work this position requires the employee to have a cell phone with a data plan and home internet service, both are reimbursed at a set rate each month. All hires are required to maintain residence in California. This is a hybrid position with employees coming into the office in downtown Sacramento.
Total Rewards:
CPCA offers a comprehensive total rewards package that includes hybrid work schedule, employer paid medical, dental, vision, life, and AD&D insurance for employees. A retirement savings plan with an employer contribution of 5%. A time off package that includes vacation, sick, float-time, and a generous holiday schedule. Employees also have access to an employer sponsored EAP, and various voluntary insurance plans, one that includes pet insurance.
Equal Opportunity Employment:
CPCA’s workforce strives to represent California’s population, while also meeting the highest standards and qualifications of our industry.
