Program Manager II – Health Economics

SANTA CLARA COUNTY, CA
Published
September 22, 2022
Location
San Jose, CA
Job Type
 

Description

Under general direction, to plan, organize, direct and control the activities and/or staff of a County program.

The Program Manager II - Health Economics is a decision support role within Valley Health Plan's Health Economics department that will be responsible for evaluating the financial impact of various operational scenarios and contractual changes/proposals, participate and partner in the development of goal/target setting, develop operational forecasts for cost structure trends and anticipated future changes, developing and interpreting financial concepts for financial planning, and assisting with other related organizational impact analysis as needed. This position must be able to work independently or lead a small team responsible for evaluating, quantifying, and reporting on recommendations based on their evaluations to an executive level audience and also have the ability to effectively engage/consult with the management team in the implementation of the recommendations. This position will need to be able to develop a standard process for their routine financial evaluations to improve the turnaround time and build analytical capacity, establish benchmarks for spend (unit cost) and utilization through the annual rate setting process, and assist in the development and monitoring of an overall Plan performance program.

The Program Manager II - Health Economics position will need to have significant experience in evaluating, analyzing, modeling, and forecasting complex business scenarios to inform strategic decision making, be able to identify the drivers of performance and quantify the opportunities for improvement based on VHP's cost and utilization based data, be able to forecast/model various scenarios including medical and administrative expense using historical experience and anticipated cost structure changes, develop recommendations from costs/benefit analysis', support the development of actionable targets for the performance dashboard, and understand how to effectively package and present this information to an executive level audience. The individual qualified for this position must have the ability to develop robust financial/utilization-based forecasting models used for strategic planning and decision making, to include plan benefit design, enrollment scenarios, premium rate setting, hospital and physician contract cost structure impact, capitation, provider reimbursement thresholds, and programmatic impact analysis.

In addition to meeting the employment standards for Program Manager II, a qualified candidate must possess experience in the following:

  • Developing a multi-year forecast that includes total annual Health Plan revenues, expenses, and enrollments.
  • Evaluating the financial impact of Hospital contracts.
  • Evaluating the financial impact of a Medical Group's non-capitated contract on a Health Plan's financial cost structure.

COVID-19 Risk Tier - Lower Risk

Typical Tasks

  • Plans, organizes and directs a County program that provides direct service to the public or other agencies;
  • Determines program objectives in light of established goals;
  • Develops strategies to achieve objectives;
  • Establishes program priorities;
  • Formulates and implements policies, plans and procedures for carrying out functions of the program;
  • Defines personnel resource needs and allocates them as required to reach program objectives;
  • Selects and hires staff and ensures the orientation, training and development of program staff;
  • Directs and evaluates the work of subordinate staff;
  • Establishes an appropriate organizational structure and delineates working level and relationships of personnel to carry out the program's activities;
  • Determines budgetary requirements to maintain the program;
  • Makes recommendations on the annual budget and may present the program's budget to the Board of Supervisors;
  • Is responsible for determining program funding needs and obtaining available outside funding when necessary through grants and/or contracts;
  • Is responsible for the implementation, control, monitoring and evaluation of provided services to ensure compliance with terms of received grants and contracts;
  • Maintains liaison relationships and represents the program in contacts with public and private agencies and concerned community groups and organizations;
  • Prepares reports and correspondence;
  • Keeps abreast of new trends and developments related to the program's activities;
  • Provides assistance and advice to advisory and planning boards, commissions, task forces and other special groups as required;
  • May prepare and make presentations to staff, boards, commissions, and external groups;
  • May provide ongoing statistical reports;
  • May be assigned as a Disaster Service Worker, as required;
  • And performs related duties as required.

Employment Standards
Sufficient education, training and experience to demonstrate the possession and direct application of the following knowledge and abilities.

Training and Experience Note: The required knowledge and abilities are typically attained through training and experience equivalent to possession of a Bachelor's degree. Relevant experience can substitute for education on a year-for-year basis. Relevant experience includes experience performing analytical, administrative, lead, supervisory, or management duties, which include interpreting rules and regulations, gathering data and formulating recommendations, and report writing.

AND

Five (5) years of analytical, administrative, lead, supervisory or management experience which includes duties interpreting rules and regulations, gathering data and formulating recommendations, and report writing; two (2) years of which must be at the journey level.

A Master's degree can substitute for one (1) year of the required experience.

Special Requirements
Specialized program knowledge may be required in addition to the generalized administrative/supervisory experience when it can be demonstrated that:
it is an absolute necessity for the successful operation of the program;that the Program Manager will be held accountable for this specialized knowledge; andthat subordinate program staff will not be able to provide the subject matter expertise that is required.
Note: The knowledge, skills and abilities listed below indicate the common aspects of the three levels of the Program Manager Series. However, for recruitment purposes, a potential candidate will be rated on ability to perform at a specific level as outlined in the allocation factors. In appraising experience, more weight will be given to the breadth rather than depth of pertinent experience and the evidence of the candidate's ability to assume and fulfill the responsibilities of the position at a designated level.

Some positions may require Live Scan screening as part of the background check process.

Knowledge of:

  • Program development and evaluation;
  • Techniques of organizing and motivating groups;
  • Personnel management techniques;
  • Methods of administrative problem solving;
  • Principles of organization and administrative, fiscal and program management;
  • Principles of employee supervision, training and development;
  • Community and agency consultation methods and procedures;
  • Computer applications, including but not limited to: word processing, spreadsheets, data base management software, presentation and electronic mail software.

Ability to:

  • Plan, organize, control and evaluate a public service program;
  • Manage initiatives, collect and analyze data for the purpose of evaluating services and or programs;
  • Plan and assign workloads clearly and effectively;
  • Train, develop and motivate staff;
  • Deal effectively with a variety of government and community officials;
  • Speak effectively in public;
  • Integrate the activities of a program to attain program goals;
  • Prepare and review reports;
  • Develop and recommend effective courses of action;
  • Develop and effectively utilize all available resources;
  • Establish and maintain program's objectives, priorities and policies;
  • Consult with and advise top administrator on the activities and status of the program;
  • Develop short and long range budget plans that accurately reflect program needs.
  • May require the ability to apply the tools of a specialty subject area.

Closing Date/Time: 10/4/2022 11:59 PM Pacific

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