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(DHCS) Medi-Cal Managed Care Plan Contract Manager Full-time Job

1 year ago Medical & Healthcare Hollywood   1.2K views
Job Details

WHO WE ARE

AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation!

Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?

If so, AIDS Healthcare Foundation is the place for you!

Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

AHF’s core values are to be:

  • Patient-Centered
  • Value Employees
  • Respect for Diversity
  • Nimble
  • Fight for What’s Right

STILL INTERESTED? Please continue!

OUR CONTRIBUTION TO OUR SUCCESS!

The Medi-Cal Managed Care Plan Contract Manager ensures that AHF operates its Medi-Cal specialty health plan in accordance with federal and state regulations and AHF’s contract with the California Department of Health Care Services (DHCS). The Contract Manager plays a critical role in the Managed Care Division’s Compliance Plan. The Contract Manager is the expert on the contents of the AHF-DHCS contract. In collaboration with the Compliance Officer, he or she develops and executes an internal audit program that assesses plan operations for compliance with AHF’s contract with DHCS, DHCS-issued policy and all-plan letters, California Department of Managed Health Care (DMHC) all-plan letters and California Knox-Keene regulations.The Contract Manager is responsible to review new regulations and policies and changes to existing regulations issued by DHCS, DMHC, Centers for Medicare and Medicaid Services (CMS), etc., disseminate them to affected business unit directors and develop work plans in collaboration to ensure implementation deliverables and processes are executed by deadline. The Contract Manager works with business unit leadership to develop dashboards to monitor plan performance of functions that are specified in the AHF-DHCS contract. He or she is responsible to ensure required DHCS and DMHC reporting is compiled accurately and submitted in a timely manner.

The Contract Manager services as the principal liaison between AHF and DHCS. He or she attends DHCS and DMHC meetings, advisory boards, stakeholder meetings, etc. and reports back to Managed Care Executive Management.

Company Description
The Los Angeles-based AIDS Healthcare Foundation (AHF) is a global nonprofit organization providing cutting-edge medicine and advocacy to over 1,000,000 people in 43 countries. We are currently the largest provider of HIV/AIDS medical care in the U.S.
AHF funds its mission to rid the world of AIDS through a network of pharmacies, thrift stores, healthcare contracts and other strategic partnerships. Generating new, innovative ways of treatment, prevention and advocacy has been the hallmark of our success. We are currently leading a mass testing initiative to identify and treat the 25 million people who are unaware they are infected.