Sr Manager, Member Retention & Outreach (Sr Manager I)
CalOptima
Join Us in this Amazing Opportunity
The Team You'll Join
We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, we encourage you to review and apply today and help us build healthier communities for all.
More About the Opportunity
We are hoping you will join us as a Sr Manager, Member Retention & Outreach (Sr Manager I) and help shape the future of healthcare where you'll be an integral part of our Operations Management team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Partial Telework.
- If telework is approved, you are required to work within the State of California only and if Partial Telework, also come in to the Main Office in Orange, CA, at least two (2) days per week minimum.
The Sr Manager for Member Retention & Outreach will lead the design of and operationalize member retention and outreach programs for CalOptima's Medicare Advantage line of business. You will be responsible for developing a proactive, data-driven strategy to reduce voluntary disenrollment, improve member satisfaction and experience, and close retention gaps across the lifecycle-ensuring each interaction builds trust, supports continuity of care, and reinforces plan value. Also, you will collaborate closely with departments including Customer Service, Provider Network, Quality, Operations, and Marketing to identify and address root causes of member dissatisfaction and strengthen communication and service recovery processes. You will oversee a blended team of phone-based Retention Specialists and field-based Outreach and Engagement staff focused on reducing voluntary disenrollment, improving experience measures, and supporting member engagement. Together, we are building a stronger, more equitable health system.
Your Contributions To the Team:
- 50% - Leadership Functions
- Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
- Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department.
- Develops a comprehensive, annual Retention & Outreach Strategy Plan focused on reducing controllable disenrollments, improving Stars and CAHPS performance, and strengthening overall membership stability.
- Launches and scales member outreach and support programs - including onboarding, re-engagement, ambassador and repeat-caller initiatives- to improve retention and reduce grievances.
- Uses data and analytics to identify predictive risk indicators, inform proactive retention efforts and guide program improvements.
- Defines key performance indicators (KPIs) and develops dashboards and scorecards to monitor program effectiveness.
- Utilizes matrix management and directs and/or coordinates staff throughout the organization in the implementation of strategic growth and retention plans.
- Hires, manages, trains, reviews and sets goals for staff, including assisting in team engagement and management.
- Manages and coaches teams through activities such as building strong relationships, documenting initiatives and discussions, identifying gaps/issues/solutions, standardizing tools/templates, implementing quality departmental initiatives and reporting to stakeholders and management team.
- Manages and coordinates the day-to-day assignment of resources and shifts in work and priorities based on departmental needs.
- Develops, establishes and updates department processes to maintain operational excellence.
- Fosters ongoing relationships and mutually beneficial partnerships with internal CalOptima Health departments and external organizations.
- 45% - Program Oversight
- Conducts regular analysis of member disenrollment trends and collaborates with cross-functional partners as well as external provider networks to resolve systemic issues contributing to attrition.
- Partners with Quality and Customer Service teams to align outreach with CAHPS and HOS drivers, improving key member experience domains such as access, communication, and coordination of care.
- Collaborates with internal departments to ensure analysis and feedback informs operational, services and process improvements.
- Establishes and leads a Community Engagement and Partnerships function that strengthens local presence and member connection by enhancing CalOptima OneCare's presence in the community through community events, educational outreach and relationship building efforts that reinforce retention goals.
- Collaborates with CalOptima Health departments to plan and execute community outreach activities including member and provider outreach events, and to enhance visibility, trust and engagement.
- Develops and oversees multi-touch onboarding campaigns for new members and year-round engagement campaigns (e.g., benefit education, preventive care reminders) to close gaps in care and improve experience.
- Partners with internal teams to identify and coach lower performing medical groups and providers on strategies to improve CAHPS-related experience measures, ensuring alignment between provider performance, member satisfaction, and overall retention goals.
- Collaborates and supports organizational member experience initiatives including but not limited to: CMS Star Program operational initiatives and Hierarchical Condition Category (HCC) maintenance and improvement activities.
- Ensures implementation of OneCare member retention initiatives comply with CMS regulatory requirements and communicates with stakeholders regarding implementation of initiatives.
- 5% - Other
- Completes other projects and duties as assigned.
Do You Have What the Role Requires?
- Bachelor's degree in business administration or related field PLUS 5 years of experience in a management position of a health insurance plan, managed care organization or public agency serving Medicare and Medicaid (Medi-Cal) populations required; An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
- 4 years of progressive leadership experience, including direct supervision of staff required.
- Valid driver's license and vehicle, an acceptable driving record and current auto insurance or other approved means of transportation, will be required for work away from the primary office 25% of the time or more.
You'll Stand Out More If You Possess the Following:
- Master's degree in business administration, marketing, gerontology, health administration or related field.
- Medicare Advantage health plan marketing/outreach and operations, Medicare Advantage health maintenance organization (HMO) special needs plans (SNP), and Medicaid/Medi-Cal experience.
- Project management experience.
What the Regulatory Agencies Need You to Possess?
Your Knowledge & Abilities to Bring to this Role:
- Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
- Work independently and exercise sound judgment.
- Communicate clearly and concisely, both orally and in writing.
- Work a flexible schedule; available to participate in evening and weekend events.
- Organize, be analytical, problem-solve and possess project management skills.
- Work in a fast-paced environment and in an efficient manner.
- Manage multiple projects and identify opportunities for internal and external collaboration.
- Motivate and lead multi-program teams and external committees/coalitions.
- Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Your Physical Requirements (With or Without Accommodations):
- Ability to visually read information from computer screens, forms and other printed materials and information.
- Ability to speak (enunciate) clearly in conversation and general communication.
- Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
- Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
- Lifting and moving objects, patients and/or equipment 10 to 25 pounds
Ways We Are Here For You
- You'll enjoy competitive compensation for this role.
- Our current hiring range is: Pay Grade: 316 - $120,881 - $193,410 ($58.12 - $92.9856).
- The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors.
- This position is approved for Partial Telework (**If the position is Telework, it is eligible in California only**)
- A comprehensive benefits package
- CalPERS pension program and additional retirement packages.
- Additional benefits and perks including:
- A generous PTO program
- A quality work life balance
- Various wellness programs
- Tuition Reimbursement
- Professional development opportunities
- Career development opportunities
- Flexible scheduling
- And the satisfaction of knowing your work directly impacts and improves healthcare access for thousands of individuals and families.
Our Work Environment:
If located at the 500, 505 Building or a remote work location:
- Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
- There are no harmful environmental conditions present for this job.
- The noise level in this work environment is usually moderate.
If located at PACE:
- Work is typically indoors in a clinical setting serving the frail and elderly.
- There may be harmful or hazardous environmental conditions present for this job.
- The noise level in this work environment is usually moderate to loud.
If located in the Community:
- Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
- Employee will occasionally work outdoors in varied temperatures.
- There may be harmful or hazardous environmental conditions present for this job.
- The noise level in this work environment is usually moderate to loud.
Why Join Us?
We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare.
What's Your Next Step?
All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. Do NOT miss out. If you want to join our team, the deadline for the first review of applications is December 31, 2025 at 9:00 PM (PST). We are encouraging you to apply early. If you apply after the first review date, your application is not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.
Our Commitment to You
Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss the next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview.
If you make it through the steps above and are selected for this exciting role, you will be required to undergo a reference and a background check (to include a conviction record) and if applicable also pass a drug screening and/or a post-offer pre-employment medical examination (for specific positions) If you are an Internal CalOptima Health applicant, please apply through the internal portal on InfoNet.
We will make sure to keep you updated through each step of the process on your candidate portal. Please make sure to watch for updates on your candidate portal and you emails which will be sent to the email address you listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process.
CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.
CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.
If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.
To apply, please visit: https://jobs.caloptima.org/jobs/sr-manager-member-retention-outreach-sr-manager-i-505-city-parkway-west-california-united-states
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