Management & Executive Jobs refer to positions within an organization where individuals are tasked with making strategic decisions, overseeing operations, and leading teams towards achieving business goals. These roles typically include titles such as manager, director, vice president, and CEO, and are characterized by their high level of responsibility, authority, and often, a requirement for extensive experience and leadership skills. Executives set the vision for the company, while managers implement strategies and policies to drive success. These jobs often involve complex problem-solving, strong communication abilities, and the capacity to influence and motivate others.
Management & Executive Jobs refer to positions at the higher levels of an organization's hierarchy, involving significant responsibility over strategic planning, decision-making, and leadership. Executives set visions, goals, policies, and they often participate in high-level negotiations. Managers oversee the implementation of these directives, leading teams, managing resources, and ensuring operational efficiency. These roles demand strong leadership, communication, and analytical skills, as well as extensive experience in their respective fields. Typical titles include CEOs, CFOs, directors, and various department heads, each with a critical influence on the company's success and direction.
Management and Executive Jobs refer to positions at the higher levels of organizational hierarchy that involve overseeing operations, strategic planning, and decision-making. These roles typically include titles such as CEO, CFO, COO, department managers, and directors. Key characteristics of these jobs include leadership responsibilities, the ability to direct teams, craft strategic initiatives, and a focus on achieving company objectives through effective resource management. They generally require a combination of advanced education, extensive experience, and skills in communication, problem-solving, and critical thinking.
but are not limited to, health education and health management classes, workshops, and health screenings, as well as information regarding access to care. The Supervisor will be responsible for assisting to establish measurable goals and outcomes for the Center in collaboration with the Community Resource Center Manager.
Assist in the outreach of partnerships related to Center events and offerings to increase awareness in the surrounding community. Serve as the liaison/ambassador to internal and external clients/community partnerships. Responsible for the Center's activities calendar and ensuring appropriate and efficient utilization is maintained and lead in building and implementation
of Quality Assurance Program, instructor evaluation, curriculum design and metrics. Responsible for supervising all activities ensuring information flow to and from the Center and IEHP headquarter office.
Reviews and submits requests for payments, invoices, and other expenses for approval to the Community Resource Center Manager. NOTE: This position includes an Addendum to PART D: POSITION MAJOR FUNCTIONS which will oversee the Fitness Coach, Nutrition Coach and CRC programs. Major Functions (Duties and Responsibilities) 1. Meet or exceed daily/weekly/monthly goals for the Community Resource Center. 2. Responsible for all aspects of staff supervision to include creating a motivating and
energized work environment through strong leadership, communication, and organizational skills.
3. Responsible for maintaining and collecting quantitative and qualitative information and evaluative tracking data on Center activities. 4. Contributes to the development of the Center's operational and capital budgets and monitors for compliance and participates in the negotiation of and monitoring of contracts and subcontracts related to the Center and related activities. 5. Assist in the coordination of ongoing team meetings in addition to staff meetings with internal IEHP departments. 6. Recommends changes to policies and procedures based on Community Resource Center needs.
7. Assist Community Resource Manager in collaborating with management from Care Management, Member Services, Health Education, Health Navigator, or other departments when resolving Member issues or working on Program projects. 8. Ensure the standards for Member rights and responsibilities, such as confidentiality is maintained by staff. 9. Assist the Community Resource Manager in coordinating special projects. Ensure special projects are completed in a timely manner. 10. Nurture relationships with community-based organization partners who provide resources to families in the communities we serve.
11. Assist in the coordination of education/discussion forums surrounding various preventive health, or healthcare access topics in center territories. 12. Coordinate high volume projects/requests from multiple facets of the Community Resource Center. ADDENDUM – For Fitness Coach, Nutrition Coach and CRC Programs 1. Coordinate daily operational tasks in accordance with established Community Resource Center (CRC) policies and procedures, standard operating procedures, and job aids to ensure optimal performance results. 2. Supervise Team Members with planning, scheduling, and reviewing their scope of work while adhering to quality standards aligned with community resource center member experience.
3. Responsible for the hiring practices, training and developing, conducting performance reviews, communicate and implement the LEAN model to meet the standards, processes, and training to support growth and development. 4. Coordinate the curriculum design and oversight for the CRC’s programs, which includes MCAS/HEDIS related activities to support organizational goals, a quality assurance program and evaluation model to ensure effective services to Members and general community and provide a monthly completion of programming with calendar duties, in collaboration with the Marketing department for translation, print requests, and promotion on websites and social media.
5. Assist in reviewing usage of CRC facilities requests from external partners. 6. Facilitate and work with external partners to promote education, outreach of services and the importance of connections to the Community Resource Centers. Major Functions (Duties and Responsibilities) Cont Supervisory Responsibilities Leader: Administers Hires, Terminations, and Performance Reviews Experience Qualifications Two (2) years experience in the following: • Supervision/Lead Capacity • Managed Care/IPA/Clinic Setting • Community Outreach • Experience working with State Health Programs (Medi-Cal and Healthy Families Program) Preferred Experience Experience with Community Centers is a plus.
Education Qualifications Bachelor's degree, preferably in relevant health, social, or behavioral discipline, from an accredited institution required. Preferred Education Professional Certification Professional Licenses Drivers License Required Yes, must have a valid California Driver's license and valid automobile insurance.
Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points. Knowledge Requirement Understanding of and sensitive to multi-cultural communities. Knowledge of Medi-Cal/managed care environment preferred. Knowledge of community resources available in Riverside and San Bernardino Counties. Skills Requirement Bilingual (English/Spanish) written and verbal skills preferred. Must be fluent conversationally. Testing will be required to determine bi-lingual language level. Excellent computer skills with an emphasis on MS Office software.
Strong verbal, communication skill, and computer skills. Excellent time management, organization, and interpersonal skills. Strong verbal and written communication skills. Abilities Requirement High degree of patience. Ability to make clear presentations. Strong sound judgement and decision making. Commitment to Team Culture The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.
Working Conditions Word processing and data involving computer keyboard, viewing monitor. Setting up and cleaning up for classes. Must be able to lift 40 lbs. High amount of field work with 25% driving travel required. Flexibility to work evenings and some weekends. Position is eligible for Hybrid work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership.
Work Model Location Onsite Physical Requirements Hearing: One-on-One - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Near Visual Acuity - FREQUENTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY Keyboarding: 10-Key - FREQUENTLY Keyboarding: Traditional - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Sitting - CONSTANTLY Indoors - FREQUENTLY Lighting - CONSTANTLY A reasonable salary expectation is between $79,809.60 and $101,774.40, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work. ” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace.
As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
transitioning to and from hospitals, institutions, other acute care facilities, and skilled nursing facilities to home or community-based settings. As a licensed behavioral health clinician, the individual in this position is to utilize their clinical expertise to support and engage Members to promote positive health behaviors, assist with coordination of care, provided resource linkages, and collaborate with other Team Members of this integrated care team, as well as facility partners, to ensure a seamless transitions of care experience.
The ITC LCSW will act as a care manager for care transitions and collaborate with the ITC team members to provide transitional care services to Members
transitioning from one care setting to the next. Major Functions (Duties and Responsibilities) 1. Assist Members with care coordination needs, including, but not limited to the following: a.
Conduct comprehensive, holistic backssment both telephonically as well as in person (facility or home visits). b. Assimilate backssment information to assist, in collaboration with the ITC Team and the facility, in developing a discharge plan. c. Communicate discharge plan with Member, approved family or caregiver and other Members of the care team. d. Coordinate with internal and external health partners to support Members’ comprehensive care needs. 2. Model the highest ethical behavior in care for
Members, as well as in relationships with co-workers, Leaders, internal, and external partners.
3. Advocate for Members to receive the highest quality care, in a timely manner, within IEHP’s network by referring to appropriate internal partners such as behavioral health, Enhanced Care Management, and complex care management. 4. Provide transitional care services to Members transitioning from one care setting to the next such as assisting the Member with PCP appointments, transportations, and coordination of DME and home health. 5. Support Member through all care transitions by making outreach to ensure all care needs are met before closing the Member out to transitions of care.
providing care coordination, linkage to resources, and facilitating Member self-efficacy and self-management. 6. Participate in Integrated Transitional Care Team meetings, Interdisciplinary Care Conferences, and any other meetings as required. 7. Model continuous quality improvement philosophy and engage in quality improvement initiatives and projects. 8. Model supportive and collaborative relationships with Members, co-workers, facility partners, and community providers. 9. Engage in all IEHP Team Member training and comply with all IEHP policies. Supervisory Responsibilities Leading: Guides Others Experience Qualifications Minimum of three (3) years of experience performing Behavioral Health/Medical Social Work services.
Experience in motivational interviewing and/or other evidenced-based communication strategies. Preferred Experience Behavioral Health/Medical Social Work services experience in a health clinic psychiatric hospital, medical facility, or health care clinic strongly preferred. Experience in clinical services, both mental health and substance use preferred. Education Qualifications Master’s degree in Social Work from an accredited institution required.
Professional Licenses Possession of an active, unrestricted, and unencumbered Clinical Social Worker (LCSW) license or Marriage and Family Therapist (LMFT) license issued by the California Board of Behavioral Sciences required. Drivers License Required Yes, must have a valid California Driver's License. Knowledge Requirement Familiarity with Managed Care and discharge planning is required. Knowledgeable and skilled in evidenced-based communication such as Motivational Interviewing, or similar empathy-based communication strategies. Understanding of and sensitivity to multi-cultural communities.
Deep understanding and knowledge of mental health and substance use conditions, including both acute and chronic management. Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both. Must have knowledge of whole health and integrated principles and practices. Skills Requirement Bilingual (English/Spanish) preferred. Highly skilled in interpersonal communication, including conflict resolution. Effective written and oral communication skills, as well as reasoning and problem-solving skills. Skillful in informally and formally sharing expertise.
Must have the resiliency to tolerate and adapt to a moderate level of change and development around new models of care and care management practices. Proficient in the use of computer software including, but not limited to, Microsoft Word, Excel, Power Point. Demonstrated proficiency with all electronic medical management systems (e. g. Cisco, MHK/Care Prominence, Medi Trac, Super Search and Web Portal) is preferred. Abilities Requirement Proven ability to: - Sufficiently engage Members and providers on the phone as well as in person. - Work as a member of a team, executing job duties and making skillful decisions within one’s scope.
- Establish and maintain a constructive relationship with diverse Members, Leadership, Team Members, external partners, and vendors. - Prioritize multiple tasks as well as identify and resolve problems. - Have effective time management and the ability to work in a fast-paced environment. - Be extremely organized with attention to detail and accuracy of work product. - Have timely turnaround of assignments expected. - To form cross-functional and interdepartmental relationships. Commitment to Team Culture The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture.
A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions May include hours outside of typical business hours if needed to support regulatory compliance or quality projects. Position is eligible for Hybrid work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership.
A reasonable salary expectation is between $91,000.00 and $116,022.40, based upon experience and internal equity. Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work. ” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members.
And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
assisting Members with care coordination in respect to referral process such IPA for Durable Medical Equipment (DME), home health, and Specialist needs. 2. Responsible for assisting with the referral process by contacting providers by phone, fax, or email to request additional medical information as needed.
3. Responsible for assisting the Care Managers in the management and coordination of care of Member identified with care management conditions. 4. Responsible for facilitating Member care to ensure that a continuity of care letter of agreement (LOA) is executed when appropriate. 5. Collaborates on Member’s care issues with other team members and consults with NCM or CM supervisor to
ensure that appropriate treatment plan is followed, thoroughly and promptly. 6. Responsible for processing and coordinating divorces, disenrollment, transportations, and language interpretation as needed and applicable.
7. Assists with contact calls for monthly HRA pull, i. e. Complex Case Management and assisting with coordinating the members overall care as needed. 8. Responsible for identifying HEDIS gaps and contacting the member to address these gaps. 9. Responsible for covering Cisco ACD Queue telephone lines and Phone queue. 10. Assists with the coordination of access issues with PCP offices, specialists, radiology services and ancillary services such as PT, OT, speech therapies.
11. Ensures documentations is accurate and in compliance with regulatory requirements and accreditation standards.
12. Consults with assigned nurses for clinical backssment and decision prior to taking action that are clinical in nature. 13. Performs any other duties as assigned or required to ensure Health Plan operations are successful. 14. Participates in Medical Services staff meetings or other activities as needed 15. Ensures the privacy and security of PHI (Protected Health Information) as outlined in IEHP's policies and procedures relating to HIPAA compliance including attending annual compliance training. 16. Promotes a positive and collaborative working environment within the CM Team.
Major Functions (Duties and Responsibilities) Cont Supervisory Responsibilities Leading: Self Experience Qualifications Two (2) years customer service experience in medical clinics, hospitals, or IPAs. Preferred Experience Managed care setting experience preferred. Education Qualifications High school diploma or GED required. Preferred Education Associate's degree or Bachelor’s degree from an accredited institution preferred. Professional Certification Medical Assistant Certification preferred. Professional Licenses Drivers License Required No Knowledge Requirement Knowledge of Utilization Management including referral process, ICD-10 and CPT codes preferred.
Knowledge of utilization management process and care coordination in HMO or managed care setting. Knowledge of Medi-Cal, and Medicare managed care. Understanding of and sensitivity to multi-cultural community. Skills Requirement Excellent written and verbal communication and interpersonal skills. Strong organizational skills, typing 45 words per minute, proficient in Windows applications. Experience in data entry. Abilities Requirement Team culture is a must. Telephone courtesy and high degree of patience.
Commitment to Team Culture The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions Communication with IEHP Members, which includes intensive telephone use, basic computer knowledge and word processing/data entry skills including computer keyboard and screens, distribution of reports, filing and copying of records and/or correspondence.
Position is eligible for telecommuting/remote work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership. Work Model Location Telecommute Physical Requirements Hearing: One-on-One - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Near Visual Acuity - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY Regular contacts: co-workers, supervisor - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Keyboarding: Traditional - FREQUENTLY Sitting - CONSTANTLY Indoors - FREQUENTLY Lighting - CONSTANTLY A reasonable salary expectation is between $45,884.80 and $55,993.60, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.
” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
positions. The role is responsible for monitoring performance of the team and individual Team Members, identification of process improvement areas, developing a team approach to problem solving and developing a cohesive team. Overall, responsibilities include ensuring timely completion and response for Behavioral Health & Care Management department functions including: - Ensuring accurate completion of the authorization data entry tasks, continuity of care, and Behavioral Health authorization processes - Referrals and calls - Ensuring compliance with all regulatory and quality requirements, including but not limed to, screening, backssment, care planning, and follow-up.
Major Functions
(Duties and Responsibilities) 1. Develop effective relationships with co-workers, direct reports, and community partners, modeling excellent interpersonal skills and collaboration in working toward job duties and goals.
2. Model the importance of Member experience and engagement and engage with other leaders in BH and CM and at IEHP in developing and implementing Member and Team Member experience improvement activities. 3. Work closely with the BH and CM leadership to develop effective behavioral health care management principles, processes, and workflows as well as monitor care management services to ensure compliance with all IEHP, state and federal regulatory requirements. 4. Monitor
and provide direction to the BH and CM team to ensure implementation of timely processes and follow through of calls, task completion, care coordination and care management, including Complex Care Management responsibilities.
5. Proactively recognize problematic or risk areas and help develop effective and efficient solutions in conjunction with BH &CM Team Members. 6. Professionally represent the department at selected IEHP meetings including external events, as necessary. 7. Provide exemplary leadership and support for all assigned BH and CM Team Members ensuring Team Members are given every opportunity to succeed in their positions and are supervised in accordance with Department and Human Resources (HR) policies.
8. Discuss difficult or complex cases with Team Members, provide recommendations for further action, coach Team Members in addressing Member’s holistic needs. 9. Review and update departmental policies and procedures, as necessary. 10. Evaluate current programs for efficiency and program outcomes by analyzing specific data and providing improvement suggestions. 11. Assist in auditing services authorized by BH & CM leadership and submit statistical reports to managerial and director leadership as requested. 12. Work closely with management to coordinate daily staffing and coverage of the BH & CM Units.
13. Supervise and train BH & CM assigned Tam members including monitoring of performance standards. 14. Monitor and provide timely direction to BH & CM assigned team to ensure adherence to NCQA, CMS, DMHC and DHCS regulator standards ensuring delivery of high-quality, cost-effective services to Members. 15. Engage in direct care management activities when needed. Provide mentoring and clinical supervision of licensed and unlicensed Team Members when needed. 16. Assist in training of new staff members utilizing proficiency in all electronic medical management systems (e.
g. Med Hok, Medi Trac, Super Search and Web Portal). Supervisory Responsibilities Leader: Administers Hires, Terminations, and Performance Reviews Experience Qualifications Three (3) years of relevant progressive work experience in a healthcare setting is required. Working experience and knowledge in teams consisting of Behavioral Health, Care Management, and Team Members dedicated to addressing social determinants of health. Supervisory/lead capacity experience required. Preferred Experience Experience in a managed care organization servicing Medicaid and/or Medicare membership preferred.
Education Qualifications Bachelor’s degree in a related field from an accredited institution required. In lieu of a bachelor’s degree, one of the following applicable scenarios may be considered: 1. Candidate with an active, unrestricted, and unencumbered Registered Nurse (RN) issued by the California BRN without a bachelor’s degree will require four (4) years of additional relevant work experience. This experience is in addition to the minimum years listed in the Experience Requirements above. 2. Candidate with an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians without a bachelor’s degree will require six (6) years of additional relevant work experience.
This experience is in addition to the minimum years listed in the Experience Requirements above. Internal Candidates Only: In lieu of the required degree, a minimum of five (5) years of IEHP work experience in Health Services division is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above. Preferred Education Master’s degree from an accredited institution preferred.
Professional Licenses Possession of one (1) of the following active, unrestricted, and unencumbered clinical licenses issued by appropriate California state board required: - Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians. - Registered Nurse (RN) license issued by the California BRN. - Clinical Social Worker (LCSW) license or Marriage and Family Therapist (LMFT) license issued by the California Board of Behavioral Sciences Drivers License Required Yes, must have a valid California Driver's license and valid automobile insurance.
Must qualify and maintain driving record to drive company vehicles based on IEHP insurance standards of no more than three (3) points. Knowledge Requirement Deep understanding and knowledge of: - Behavioral health and substance use conditions, including acute and chronic management. - Awareness of the impact of unmitigated bias and judgement on health with the; commitment to addressing both. - Evidenced based communication such as Motivational Interviewing, or similar empathy-based communication strategies. - Understanding and sensitivity to multi-cultural community - Whole health and integrated principles and practices is preferred.
Skills Requirement Skilled in the following areas: - Problem-Solving: Identify and resolve problems, effective time management and the ability to work in a fast-paced environment. - Report Analysis: Comprehend and analyze statistical reports, aggregate data, make recommendations. - Effective engagement and skill development to support strong, cohesive, productive Teams. - Effective written and oral communication. - Informally and formally sharing expertise. Abilities Requirement Proven ability to: - Work as a member of a team, executing job duties and making skillful decisions.
- Function independently. - Be a self-starter. - Sufficiently engage Members and Providers. - Show resilience to tolerate a moderate level of change and development around new models of care and care management practices. Commitment to Team Culture The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.
A reasonable salary expectation is between $103,708.80 and $132,225.60, based upon experience and internal equity. Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work. ” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace.
As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
Areas of oversight for this position include, but are not limited to, case management, quality management, utilization management (UM), and grievance and appeals and committee participation. The Medical Director of Behavioral Health oversees the inpatient/concurrent review process, care integration efforts, and all levels of behavioral health care provided to IEHP Members.
The Medical Director coordinates care with the County Mental Health Plans that are responsible for the care of the population with a Serious Mental Illness (SMI), the County Alcohol and Drug Program, as well as all IEHP community and provider partners. Major Functions (Duties and Responsibilities) 1. Provides overall
clinical leadership and develops and implements clinical policies for the IEHP Behavioral Health Program. This includes delivery of mental health services, substance use services, medication management, and coordination of behavioral health services and primary care.
2. Provides direction of current clinical practices for behavioral health services. Ensures that qualified medical/clinical personnel render clinical decisions regarding behavioral health, unhindered by fiscal or administrative management, and consistent with regulatory requirements and UM guidelines. 3. Leads Behavioral Health quality improvement efforts while helping to manage health plan medical costs, assuring an appropriate
and efficient health care delivery system for IEHP Members, and supporting IEHP strategic goals.
4. Monitors performance of behavioral health providers and leads performance improvement efforts in the network to improve the quality of services delivered to IEHP members in collaboration with IEHP leadership. 5. Leads efforts to further integrate substance use treatment into the care delivery system, including implementing integrated care models that increase access to Medication Assisted Treatment (MAT) along with substance use counseling and other evidence-based addiction interventions. 6. Develops targeted education, training, and clinical guidance to contracted primary care physicians (PCPs) treating behavior health-related concerns not requiring referral to behavior health specialists.
7. Provides medical direction and guidance to the Behavioral Health Department in the arena of inpatient, outpatient pre-service authorizations and utilization management, including the coordination of care with external agencies, consultation on complex cases, and participation in Interdisciplinary Care Teams/case conferences 8. Leads, develops, directs, and implements clinical and non-clinical activities that impact health care quality, cost, and outcomes.
9. Reviews cases and ensures appropriate adjudication of prior authorization. Directly reviews all medical necessity denials and modifications of a prior authorization requests. 10. Ensures the creation, modification, and appropriate and timely use of UM criteria for both inpatient and outpatient authorizations. 11. Identifies and develops opportunities for innovation to increase effectiveness and quality. 12. Ensures that assigned patients have access to behavioral health services coordinated with primary and specialty care throughout IEHP’s geographic coverage area. Partners with the Contracting Department to ensure a full and appropriate primary and specialty behavioral health care provider network for Members.
13. Consults on written protocol for IEHP behavioral health providers to ensure adherence to standards and quality of care. Coordinates professional interactions among practitioners and lends assistance toward correcting any deviation from standards. Develops relationships with directly contracted behavioral health providers. 14. Reviews State mandated benefits to ensure the IEHP Behavioral Health Program is in full compliance through its providers. 15. Partners with Behavioral Health leadership in curriculum development designed to promote a comprehensive, effective, and equitable behavioral health program.
16. Any other duties as required ensuring Health Plan operations are successful. Supervisory Responsibilities Leader: Administers Hires, Terminations, and Performance Reviews Experience Qualifications Five (5) years of post-residency or Licensure experience in a recognized psychiatric specialty. Preferred Experience At least three (3) years of psychiatric administrative experience preferred. Preferred experience is in a variety of clinical settings including inpatient psychiatric, outpatient practice, and community-based care settings.
Utilization Management experience with an IPA, medical group or HMO highly desirable. Experience with Medi-Cal managed care is a plus. Education Qualifications Doctorate of Medicine from an accredited institution required. Professional Certification Certification by an American Specialty Board in Psychiatry. Professional Licenses Possession of an active, unrestricted, and unencumbered Physician’s and Surgeon’s Certificate issued by the State of California Medical Board required. (A physician certified in a state other than California may be employed prior to receipt of California certification provided that an application for a California physician and surgeon’s certificate is filed in the state of California prior to date of appointment.
) Drivers License Required Yes, must have a valid California Driver's License. Knowledge Requirement Administrative practices and procedures including but not limited to quality backssment and improvement, utilization review, peer review, Credentialing and risk management; rules regulations, policies, and standards related to managed care; principles of effective supervision and organization; methods, techniques, practices, principles, and literature in the broad field of medical sciences; and overview of the highly specialized techniques, procedures, and equipment used in the medical or surgical specialties.
Skills Requirement Microcomputer applications such as Microsoft Word, Excel, and Access helpful. Commitment to Team Culture The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.
Working Conditions While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.
Position is eligible for Hybrid work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership. Work Model Location Hybrid Physical Requirements Keyboarding: Traditional - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Hearing: One-on-One - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Near Visual Acuity - FREQUENTLY Sitting - CONSTANTLY Indoors - FREQUENTLY Lighting - CONSTANTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY A reasonable salary expectation is between $240,676.80 and $330,928.00, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work. ” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members.
And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
Including consulting with departments in selection of the most equitable and efficient solicitation process, in negotiations, and for contract implementation. This position possesses knowledge of the most appropriate procurement/contract type to reduce IEHP's exposure to risk.
Adhering to the public sector procurement processes ensuring compliance with IEHP’s procurement awards based on best value, applied industry standards and best practices, Legal, Governing Board policies, and State and Federal requirements. Major Functions (Duties and Responsibilities) 1. Performs all procurement related activity, planning, evaluation of proposals, recommends a wide range of awards. 2. Assists in
developing and defining contract/bid specifications; writes solicitations (Request for Proposals, Requests for Quotations, and Invitations to Bid); analyzes and determines most appropriate contract types to reduce IEHP's exposure to risk.
3. Review and adheres to compliance of departmental policy, procedure, fiscal, State and Federal regulations of procurement/contracts/ First-Tiered Downstream and Related Entities requirements including sanction exclusion screening process 4. Participates in the negotiation of contracts terms and conditions between IEHP and contractors; monitors negotiation sessions to ensure ethical procurement practices are followed; advises IEHP departments on the
type, form, and context of the final contract negotiated; mediates disputes in an attempt to reach equitable agreement 5.
Compose clear and concise reports, recommendations, and correspondence. Performs market research, analyzes total life cycle cost, best value, price, and complex cost analysis in formulating forecasts and recommendations for procuring commodities or service 6. Work independently to read and interpret rules and regulations. Collect, organize, and evaluate information; identify alternative solutions, and project consequences of decisions and recommendations. 7. Identifies and recommends process improvement methods concerning procurement and supply problems; ensure that all outcomes deliberated with internal and external customers are fair, reasonable, and within the law.
8. Verifies fund availability; maintains records pertaining to all requests and purchases. 9. Communicate in a clear and persuasive manner; establish and maintain effective relationships with department officials, company/vendor representatives, and staff members. 10. Prepares Board Letters and related supplemental paperwork in support of contracts for the Board; prepares analytical reports, correspondence, and memoranda. 11. Receive, research, and assist Legal with the public requests according to the California Public Records Act(California Government Code §§.
6250 et seq. ). 12. Effectively utilize computers and appropriate procurement software systems. Major Functions (Duties and Responsibilities) Cont Supervisory Responsibilities Leading: Self Experience Qualifications Two (2) years of professional procurement experience in a Procurement Department or Agency, which included contract negotiation, development of contract standards and procedures, and development of multi-year or major high-value multi-commodity agreements or equivalent work experience.
Preferred Experience Education Qualifications Associate’s degree from an accredited institution required. In lieu of the required degree, a minimum of two (2) years of additional relevant work experience or progressive procurement experience in a Procurement Department or Agency, which included contract negotiation, development of contract standards and procedures, and development of multi-year or major high-value multi-commodity agreements is required for this position. This experience is in addition to the minimum years listed in the Experience Requirements above. Preferred Education Bachelor’s degree from an accredited institution preferred.
Professional Certification Professional Licenses Drivers License Required No Knowledge Requirement Current and extensive knowledge of governmental procurement methods, procedures, and automated purchase requisition and contract management systems. Public Agency contracting principles including RFP/RFQ preparations, Public Works, contract negotiation, contract law and basic financial analysis. Skills Requirement Analytical and Written Skills. Customer Service Skills desired. Effective Communication. Abilities Requirement Commitment to Team Culture The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture.
A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions Word processing involving computer keyboard and screens, filing, and copying of records and/or correspondence. Must be able to sit for extended periods of time and move to locations within and outside of the building to attend meetings, training, and similar events.
Position is eligible for telecommuting / remote work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership. Work Model Location Telecommute Physical Requirements Keyboarding: Traditional - FREQUENTLY Keyboarding: Touch-Screen - FREQUENTLY Keyboarding: 10-Key - FREQUENTLY Indoors - FREQUENTLY Sitting - CONSTANTLY Lighting - CONSTANTLY Hearing: One-on-One - FREQUENTLY Communicate: Information/ideas verbally - FREQUENTLY Near Visual Acuity - FREQUENTLY Regular contacts: co-workers, supervisor - FREQUENTLY Memory - FREQUENTLY Understand and follow direction - FREQUENTLY Regular and reliable attendance - CONSTANTLY A reasonable salary expectation is between $61,422.40 and $78,312.00, based upon experience and internal equity.
Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as “Great Place to Work.
” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
Management & Executive Jobs refer to positions within an organization where individuals are tasked with making strategic decisions, overseeing operations, and leading teams towards achieving business goals. These roles typically include titles such as manager, director, vice president, and CEO, and are characterized by their high level of responsibility, authority, and often, a requirement for extensive experience and leadership skills. Executives set the vision for the company, while managers implement strategies and policies to drive success. These jobs often involve complex problem-solving, strong communication abilities, and the capacity to influence and motivate others.
Management & Executive Jobs refer to positions within an organization that involve overseeing operations and making strategic decisions to guide the company towards its objectives. These roles are characterized by leadership responsibilities, high-level planning, and typically require extensive experience. Executives set the vision and goals, while managers ensure that daily activities align with these directives. Such positions often demand strong communication and interpersonal skills, as well as the ability to solve complex problems and adapt to changing business environments.
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Management & Executive Jobs refer to positions within an organization where individuals are tasked with making strategic decisions, overseeing operations, and leading teams towards achieving business goals. These roles typically include titles such as manager, director, vice president, and CEO, and are characterized by their high level of responsibility, authority, and often, a requirement for extensive experience and leadership skills. Executives set the vision for the company, while managers implement strategies and policies to drive success. These jobs often involve complex problem-solving, strong communication abilities, and the capacity to influence and motivate others.
Management & Executive Jobs refer to positions within an organization that involve overseeing operations and making strategic decisions to guide the company towards its objectives. These roles are characterized by leadership responsibilities, high-level planning, and typically require extensive experience. Executives set the vision and goals, while managers ensure that daily activities align with these directives. Such positions often demand strong communication and interpersonal skills, as well as the ability to solve complex problems and adapt to changing business environments.
