UCLA Health

Description

We're seeking an Account Manager to join our Delegation Oversight Program and play a pivotal role in supporting our mission. This dynamic position ensures that our delegated entities, including Independent Physician Associations (IPAs) and other vendors, meet regulatory standards, contractual obligations, and organizational policies.

You will:

• Monitor and ensure delegated entities adhere to regulatory standards, contractual obligations, and UCLA Health policies.
• Utilize performance data to identify areas for improvement and implement strategies for continuous enhancement.
• Build strong relationships with internal and external teams to drive performance improvements and ensure compliance.
• Proactively address potential risks and support corrective action plans to enhance operational efficiency.
• Ensure the Delegation Oversight Program is always prepared for audits and regulatory reviews.
• Support the development and standardization of processes to improve member outcomes and operational effectiveness.
• Contribute to strategic initiatives aligned with organizational priorities, driving innovation and performance improvements.

Salary Range: $68,800-$141,000/annually

Qualifications

We are seeking a detail-oriented, self-directed individual with:

• A Bachelor’s degree in Healthcare Administration, Business Administration, or a related field, or a combination of equivalent education and experience, required
• A Master’s degree in a relevant field or advanced certifications in healthcare operations, highly desired
• 5 or more years of experience in health plan operations, compliance, or delegation oversight, required
• In-depth knowledge of Medicare Advantage (MA), NCQA standards, and CMS regulatory requirements, required
• Proven experience with Independent Physician Associations (IPAs) or managing delegated vendor relationships, required
• Strong analytical skills with the ability to identify risks, assess data, and drive performance improvement initiatives, required
• Excellent interpersonal and communication skills, with the ability to build and maintain collaborative relationships with both internal and external stakeholders.
• Proficiency in performance monitoring tools and data analysis software such as Innovare, Tableau, and Excel, required
• Experience with Lean methodologies and their application in healthcare operations, particularly in driving performance improvements through tools like Kaizen events and A3 problem-solving
• Familiarity with project management methodologies and tools