Health Plan and Operations Manager

Requirements

• Bachelor's degree in Business, Accounting, Finance, Healthcare Administration, or related field
• 3+ years of managed care, health plan, IPA, MSO, or PACE operational experience
• Working knowledge of Medi-Cal, Medicare, and/or dual-eligible populations
• Experience with claims, enrollment, provider operations, or delegated vendor coordination
• Familiarity with CMS and DHCS regulatory requirements
• Comfort operating in evolving, build-as-you-go environments preferred

Additional Information

Imagine a center where our seniors can receive transformative health care that will allow them to age at home and in their communities. At Asian Health Services, we recognize that so many of our elderly patients continue to struggle to get the care they need because of challenges that go beyond the walls of the clinic. To address these gaps, we've found a solution and model of care that integrates the quality care our elders receive at our health center with the most comprehensive support system, like transportation, culturally-inclusive meals, and social activities, our elders deserve. We are building a Program of All-Inclusive Care for the Elderly (PACE) to bring life-changing, culturally competent care to low-income seniors-supporting them as they age safely and with dignity, right in their communities. Based on the PACE model, SpringLight Health will offer coordinated medical care, transportation, meals, social activities, medication management, and caregiver support-all tailored to each individual's needs. Learn more by visiting our website here. Job Summary: This role presents an exciting opportunity for a detail-oriented, operationally strong professional to support the build-out and day-to-day functioning of health plan operations for a new PACE program. The Manager will be responsible for executing and coordinating key operational workflows across claims, enrollment, provider relations, pharmacy support, and care coordination, working closely with senior leadership to ensure compliance, vendor performance, and participant-centered service delivery. Note: 1.0 FTE equals 40 hours per week.

Your Match

How well this role fits your profile.

Company Intel

What employees say

Worked at Asian Health Services? Share your experience