Central California Alliance for Health

• Supports Medicare operations, sales, and enrollment functions through analysis and interpretation of Medicare and Medi-Cal data and ensures compliance with applicable state and federal regulations • Conducts complex research and analysis in support of Medicare Operations activities • Acts as a subject matter expert and liaison to internal and external stakeholders

Title: Risk Adjustment Director Locations: Mariposa County, California; Merced County, California; Monterey County, California; Santa Cruz County, California; San Benito County, California; Remote, California OUR COMMITMENT TO A HUMAN HIRING PROCESS We believe every candidate deserves thoughtful consideration. That’s why we do not use AI or automated systems to review applications. Every application is reviewed by a real human member of our team. Because we take the time to give each submission the attention it deserves, our review process may take a little longer — and we genuinely appreciate your patience as we work through applications carefully and respectfully. SERVICE AREA PREFERENCE While we encourage all interested applicants to apply, we do give priority to those who live in, or near, our service counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa. Our mission of accessible, quality health care guided by local innovation leads everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment. We have an opportunity to join the Alliance as the Risk Adjustment Director leading the Risk Adjustment Department. This position can be located in one of our service counties (Mariposa, Merced, Monterey, Santa Cruz, or San Benito) or remotely in California with expected travel to Alliance service area(s) once a quarter. Must reside in California upon hire. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Chief Financial Officer, you will: - Provide strategic management oversight in designing, implementing, directing, and monitoring the Alliance’s Risk Adjustment Department functions - Direct the Risk Adjustment Department, act as a subject matter expert, and provide executive-level advice and guidance on coding and risk adjustment methodologies and overall business operations - Direct, manage, and supervise Risk Adjustment Department staff ABOUT THE TEAM The Finance Division acts as the guardian of the Alliance’s financial health. We track the pulse of the organization by analyzing budgets, forecasting future performance, and navigating the ever-changing economic and political landscape. To keep the Alliance financially strong and secure, we wear several hats and partner with every department in the organization to translate fiscal data into insights and action. From managing funds to risk management and compliance, we ensure the Alliance’s responsible use of public funds. This role will lead Medicare DSNP Risk Adjustment strategy and execution, overseeing a high-performing team of three. Current DSNP membership is approximately 800, with projected growth to 2,000 by year-end. While this is a leadership position, the current stage of the program requires a hands-on approach. The Director will be responsible for both guiding the strategic direction and directly supporting key operational initiatives to ensure program stability and scalability. This leader will work closely with cross-functional stakeholders to drive alignment, educate on program priorities, and advance key initiatives. Success in this role will require strong collaboration and influence to accelerate progress and embed risk adjustment best practices across the organization. As the DSNP program evolves, this role will play a pivotal leadership role in scaling capabilities across physician engagement, cross-functional program coordination, and operational infrastructure. The scope and complexity of responsibilities will grow in alignment with membership expansion and organizational priorities. THE IDEAL CANDIDATE - A motivated and seasoned leader in the managed care industry, with expertise in risk adjustments - Excellent communication skills, with strength in building relationships and partnering with cross-functional teams. - Champion accountability across the organization - Experience in overseeing the Medicare Risk Adjustment life cycle - Strong data and analytical skills, including SQL, dashboarding, and reporting - Be invested in staff development and empowering teams to do their best work - Medi-Cal experience is a plus - IPA/Medical Group experience highly desired WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description and list of requirements, click here. - Knowledge of: - The managed care industry and of Medicare health insurance payment methodologies - Medicare (Hierarchical Condition Categories) risk adjustment models - Methods and techniques of developing and delivering data management strategies that support contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations - Principles and practices of provider reimbursement methodologies, pricing, and fee schedules for all provider types, including hospital, physician, and ancillary providers - Healthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical, and provider types - Methods and techniques of valuating for physician and inpatient and outpatient hospital costs - Ability to: - Demonstrate strong analytical skills, accurately collect, manage, and analyze data, identify issues, offer recommendations and potential consequences, and mitigate risk - Perform complex analysis related to rate negotiations, health care cost reports, and determination of rates for hospitals, clinics, long-term care facilities, allied health services, professional services, and specialist services - Develop, plan, organize, and direct finance programs and activities that are complex in nature and regional in scope - Provide leadership, facilitate meetings, and partner with and guide managers and employees in the resolution of issues - Demonstrate a collaborative management style, build rapport, demonstrate excellent public relations skills, and effectively manage internal and external business relationships - Education and Experience: - Bachelor’s degree in Finance, Business, Healthcare Administration, Mathematics, Statistics, or a closely related field - A minimum of ten years of experience in healthcare finance or analytics, which included a minimum of five years of experience with Medicare risk adjustment processes, a minimum of two years of experience related to Medicare Managed Care Programs, and a minimum of three years of supervisory experience (a Master’s degree may substitute for two years of general healthcare finance or analytics experience); or an equivalent combination of education and experience may be qualifying OTHER INFORMATION - We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams. - While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. - In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. COMPENSATION INFORMATION - Zone 1 Pay Range: $210,000 - $250,000 Typical areas in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas - Zone 2 Pay Range: $200,000 - $235,000 Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento) The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. The hiring ranges represent a good‑faith estimate of what we expect to pay for this role upon hire and are not the full compensation ranges. Employees typically have opportunities for growth within the full compensation range over time based on performance and merit. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location). OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance. - Medical, Dental and Vision Plans - Ample Paid Time Off - 12 Paid Holidays per year - 401(a) Retirement Plan - 457 Deferred Compensation Plan - Robust Health and Wellness Program - Onsite EV Charging Stations ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet. The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

• Designs and validates managed care payer models and performs moderately complex analysis to evaluate the feasibility of payer reimbursement methodologies • Conducts moderately complex financial analysis to support successful payer reimbursement outcomes • Coordinates and collaborates with internal and external stakeholders to achieve payer reimbursement objectives

Title: Care Coordinator - Behavioral Health (Temporary) Locations: Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, California Hybrid Job Description: OUR COMMITMENT TO A HUMAN HIRING PROCESS We believe every candidate deserves thoughtful consideration. That's why we do not use AI or automated systems to review applications. Every application is reviewed by a real human member of our team. Because we take the time to give each submission the attention it deserves, our review process may take a little longer - and we genuinely appreciate your patience as we work through applications carefully and respectfully. SERVICE AREA PREFERENCE While we encourage all interested applicants to apply, we do give priority to those who live in, or near, our service counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa. Our mission of accessible, quality health care guided by local innovation leads everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment. ABOUT THIS TEMP POSITION This is a temporary position and the length of assignment is estimated to go from May 2026 through November 2026. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Care Coordination Supervisor - Behavioral Health, this position: - Assists the Behavioral Health Care Management team with providing behavioral health care coordination activities for Alliance members - Establishes and maintains effective working relationships with provider offices, County departments and other community agencies, and internal stakeholders related to care coordination for members WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description and list of requirements, click here. - Knowledge of: - The principles and practices of health care systems - The principles and practices of care coordination - The principles and practices of customer service - The diverse needs of the Medi-Cal population - Ability to: - Understand the workings of the Alliance, particularly the Enhanced Health Services, Utilization Management, and Member Services departments - Communicate program mission, vision, and roles - Quickly learn and competently navigate Microsoft Excel and Alliance computer systems - Interpret, explain, and apply policies, procedures, and guidelines - Education and Experience: - High school diploma or equivalent - Three years of experience related to care coordination in a health care setting which involved interacting with members, patients, and providers in meeting their service needs (an Associate's degree in Health, Social Services, or a related field or current certification as a Medical Assistant may substitute for one year of the required experience); or an equivalent combination of education and experience which would provide the required knowledge, skills and abilities may be qualifying OTHER INFORMATION - We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft Teams. - While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. - In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. - This is a temporary position and does not provide the benefits that are listed below (this is standard language from our regular job posts and cannot be altered or removed). Temporary employees on assignment at the Alliance will be connected to a staffing agency with separate benefit options. COMPENSATION INFORMATION - Zone 1 Pay Range: $26.80 - $34.25 Typical areas in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas - Zone 2 Pay Range: $25.15- $32.70 Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento) The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to answer any questions that you have or share the applicable pay zone for your location if it's not one of the typical areas listed. The posted hiring ranges represent a good‑faith estimate of what a temporary employee would be paid on this assignment. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location). OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance. - Medical, Dental and Vision Plans - Ample Paid Time Off - 12 Paid Holidays per year - 401(a) Retirement Plan - 457 Deferred Compensation Plan - Robust Health and Wellness Program - Onsite EV Charging Stations ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet. The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

Title: Health Services Authorization Coordinator II (Temporary) Location: Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, California Job Description: We believe every candidate deserves thoughtful consideration. That's why we do not use AI or automated systems to review applications. Every application is reviewed by a real human member of our team. Because we take the time to give each submission the attention it deserves, our review process may take a little longer - and we genuinely appreciate your patience as we work through applications carefully and respectfully. SERVICE AREA PREFERENCE While we encourage all interested applicants to apply, we do give priority to those who live in, or near, our service counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa. Our mission of accessible, quality health care guided by local innovation leads everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment. ABOUT THIS TEMP POSITION This is a temporary position and the length of assignment is estimated to go from May 2026 through December 2026. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Health Services Authorizations Supervisor, this position: - Processes basic to complex incoming treatment and referral authorization requests and verifies member plan eligibility - Performs complex research on member authorization requests WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description and list of requirements, click here. - Knowledge of: - Medical terminology or billing codes procedures - The principles and practices of customer service - Standard business office practices and equipment - Ability to: - Verify eligibility information utilizing various organizational sources - Interpret, explain and apply processes, policies and procedures - Quickly learn each line of business conducted by the health plan - Identify, maintain, and protect Personal Health Information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and follow Alliance policies and procedures to ensure the security of such information - Education and Experience: - High School Diploma or equivalent - Three years of experience in the health care field, including a minimum of one year of experience performing health services authorization coordination duties (an Associate's degree may substitute for one year of the general health care experience); or an equivalent combination of education and experience which would provide the required knowledge, skills and abilities may be qualifying OTHER INFORMATION - We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft Teams. - While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. - In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. - This is a temporary position and does not provide the benefits that are listed below (this is standard language from our regular job posts and cannot be altered or removed). Temporary employees on assignment at the Alliance will be connected to a staffing agency with separate benefit options. COMPENSATION INFORMATION - Zone 1 Pay Range: $22.13 - $28.77 Typical areas in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas - Zone 2 Pay Range: $20.79 - $27.02 Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento) The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to answer any questions that you have or share the applicable pay zone for your location if it's not one of the typical areas listed. You can reach out to careers@thealliance.health, and a member from our Talent Acquisition team will be in touch. The posted hiring ranges represent a good‑faith estimate of what a temporary employee would be paid on this assignment. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location). OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance. - Medical, Dental and Vision Plans - Ample Paid Time Off - 12 Paid Holidays per year - 401(a) Retirement Plan - 457 Deferred Compensation Plan - Robust Health and Wellness Program - Onsite EV Charging Stations ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet. The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

Title: Claims Operations Manager Locations: Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, California; Remote, California OUR COMMITMENT TO A HUMAN HIRING PROCESS We believe every candidate deserves thoughtful consideration. That’s why we do not use AI or automated systems to review applications. Every application is reviewed by a real human member of our team. Because we take the time to give each submission the attention it deserves, our review process may take a little longer — and we genuinely appreciate your patience as we work through applications carefully and respectfully. SERVICE AREA PREFERENCE While we encourage all interested applicants to apply, we do give priority to those who live in, or near, our service counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa. Our mission of accessible, quality health care guided by local innovation leads everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment. We have an opportunity to join the Alliance as the Claims Operations Manager leading the Claims Operations Unit within the Claims Department. This position can be located in one of our service counties (Mariposa, Merced, Monterey, Santa Cruz, or San Benito) or remotely in California with expected travel to Alliance service area(s) once a quarter. Must reside in California upon hire. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Claims Director, this position: - Manages and leads the Claims Operations Unit, acts as a subject matter expert, and provides guidance on claims operations functions and departmental operations - Provides management oversight related to planning, leading, and implementing claims operations activities, including audits, root-cause analysis, quality reporting, compliance coordination, and governance of claims policies and procedures - Oversees the full Provider Dispute Resolution (PDR) lifecycle to ensure accurate, timely, and compliant dispute resolution - Manages, supervises, mentors, and trains assigned staff ABOUT THE TEAM We support the health of our provider relationships. Our teams work closely together to support Alliance members' access to care by ensuring medical services are paid to network providers accurately and on time. THE IDEAL CANDIDATE - Strong understanding of end-to-end claims and PDR operations (volume, accuracy, turnaround) - Uses data and tools to spot trends, make decisions, and actively identify opportunities for automation - Solid experience with Medi-Cal and Medicare, with compliance built into how they work - Focuses on fixing root causes instead of quick fixes - Builds, engages, and supports teams through coaching, accountability, and clear expectations - Brings new ideas, challenges the way things are done, and works closely with other teams to drive better outcomes WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description and list of requirements, click here. - Knowledge of: - Claims processing functions, including data entry, adjudication, and PDR workflows - Medi‑Cal, Medicare, and related regulatory requirements that impact claims processing and dispute resolution - Operational improvement activities, workflow design, and inventory management within a managed care environment - Medical terminology, billing practices, and coding standards relevant to claims adjudication - Audit processes, quality standards, and compliance requirements, related to claims operations and dispute workflows - Research, analysis and reporting methods - Ability to: - Train, mentor, supervise, and evaluate the work of staff, promote an atmosphere of teamwork and cooperation, and motivate staff to achieve goals and objectives - Develop work plans and workflows and organize and prioritize unit activities to meet performance metrics - Organize and prioritize the work of others, delegate effectively, and follow up on work assignments - Interpret, apply and explain complex principles, policies, regulations, terms and procedures related to area of assignment - interpret operational data, identify trends, and apply insights, collaborate with Claims Quality on PDR analytics, and identify opportunities for increased auto‑adjudication - Education and Experience: - Bachelor’s degree in Business, Healthcare Administration, Public Health, or a related field - A minimum of six years of experience in a healthcare or managed care environment which included a minimum of three years of supervisory or management experience in Medi-Cal and Medicare claims operations (a Master’s degree may substitute for two years of the general healthcare or managed care experience); or an equivalent combination of education and experience may be qualifying OTHER INFORMATION - We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams. - While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. - In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. COMPENSATION INFORMATION - Zone 1 Pay Range: $118,000 - $148,000 Typical areas in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas - Zone 2 Pay Range: $110,000 - $140,000 Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento) The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to provide the full compensation range for the role, answer any questions that you have, or share the applicable pay zone for your location if it’s not one of the typical areas listed. The hiring ranges represent a good‑faith estimate of what we expect to pay for this role upon hire and are not the full compensation ranges. Employees typically have opportunities for growth within the full compensation range over time based on performance and merit. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location). OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance. - Medical, Dental and Vision Plans - Ample Paid Time Off - 12 Paid Holidays per year - 401(a) Retirement Plan - 457 Deferred Compensation Plan - Robust Health and Wellness Program - Onsite EV Charging Stations ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet. The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

Role Description We have an opportunity to join the Alliance as the Application Services Director overseeing the Application Services Department. This position can be located in one of our service counties (Mariposa, Merced, Monterey, Santa Cruz, or San Benito) or remotely in California with expected travel to Alliance service area(s) approximately once a quarter. Must reside in California upon hire. Reporting to the Chief Information Officer, this position: - Provides strategic management oversight in implementing, directing and monitoring the Alliance’s Application Services Department functions. - Directs the Application Services Department, acts as a subject matter expert, and provides direction and advice on application development functions and overall business operations. - Directs, manages and supervises Application Services Department staff. Qualifications - Be a well-seasoned leader with expertise in application lifecycle management. - Have experience in large scale, enterprise software implementation (Claims, Care Management, ERP or CRM experience a plus). - Be well-versed in application development best practices, including the design of reference architecture. - Enhance operations by establishing metrics, analyzing processes, and implementing standard methodologies and tools to ensure high-quality deliverables. - Operationalize the organization's strategic vision for enterprise applications and operational efficiency. - Have skill in reducing barriers and moving the work forward. - Be collaborative and a true team player, with strength in mentoring teams. - Be effective at managing priorities and deadlines and empowering teams to do their best work. Requirements - Knowledge of methods and techniques associated with executing the full Application Management Lifecycle (ALM) & Software Development Lifecycle (SDLC), including analysis, technical design, development, testing, release, and support. - Software development processes. - Software and systems architecture development. - Promoting and applying change management principles. - Secure healthcare electronic information exchange, including protocol standards, messaging standards, data types and elements. - Ability to direct, manage, supervise, mentor, train and evaluate the work of staff. - Provide leadership, facilitate meetings, and partner with and guide managers and employees in the resolution of issues. - Act as a technical resource and explain complex laws, regulations, processes, and programs related to area of responsibility. - Demonstrate strong analytical skills, accurately collect, manage and analyze data, identify issues, offer recommendations and potential consequences, and mitigate risk. - Review and assess overall department function, core work, goals and structure, develop and implement short- and long-term planning to achieve strategic plans, and complete an annual department assessment. Education and Experience - Bachelor’s degree in Computer Science, Management Information Systems or a related field. - A minimum of ten years of experience related to application services and development and electronic data interchange, including a minimum of three years of experience in a healthcare environment and a minimum of three years of management-level experience (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying. Benefits - Medical, Dental and Vision Plans. - Ample Paid Time Off. - 12 Paid Holidays per year. - 401(a) Retirement Plan. - 457 Deferred Compensation Plan. - Robust Health and Wellness Program. - Onsite EV Charging Stations. Company Description We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties.

• Supports Medicare operations, sales, and enrollment functions through analysis and interpretation of Medicare and Medi-Cal data and ensures compliance with applicable state and federal regulations • Conducts complex research and analysis in support of Medicare Operations activities • Acts as a subject matter expert and liaison to internal and external stakeholders

Role Description This is a temporary position and the length of assignment is estimated to go until December 31, 2026. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with. Reporting to the Medicare Sales Director, this position: - Increases membership in the Alliance Medicare D-SNP program through direct sales and marketing of Alliance Medicare products to dual-eligible, Medicare/Medi-Cal recipients within assigned service area. - Develops a sales network to generate leads and provide opportunities for outreach. - Supports Medicare Sales Department activities and programs. Qualifications - Bilingual (English/Spanish). - A current license to sell Accident and Health or Sickness insurance issued by the State of California Department of Insurance. - Possession of current AHIP certification. - Background in Medicare sales. - Skilled in communicating complex products by simplifying information for audiences of all backgrounds. - Experience using CRM tools, nurturing leads, and following up with potential members. - A collaborative and professional communication style, building productive relationships with potential members and internal Alliance teams. Requirements To read the full position description and list of requirements, click here. - Knowledge of the Medicare program and related regulations. - CMS regulations related to Medicare sales. - The principles and practices of sales techniques utilized in a highly regulated industry. - Ability to quickly develop an in-depth knowledge of all Alliance Medicare and Medi-Cal products and provider networks within assigned service area. - Accurately identify and qualify prospective members. - Assess individuals' insurance needs and recommend appropriate coverage. - Execute defined sales strategies and achieve program goals and objectives. - Possession within three months of hire and continued maintenance of a license to sell Accident and Health or Sickness insurance issued by the State of California Department of Insurance. - Possession within three months of hire and continued maintenance of current AHIP certification. - Bachelor's degree in Business, Marketing, Healthcare Administration or a related field and a minimum of five years of experience in insurance sales, pharmaceutical sales, medical equipment sales, or a related area (an additional four years of experience may substitute for the Bachelor's degree); or an equivalent combination of education and experience may be qualifying. Benefits - Medical, Dental and Vision Plans. - Ample Paid Time Off. - 12 Paid Holidays per year. - 401(a) Retirement Plan. - 457 Deferred Compensation Plan. - Robust Health and Wellness Program. - Onsite EV Charging Stations. - And many more. Company Description We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer. Join us at Central California Alliance for Health (the Alliance) is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors and people with disabilities in Mariposa, Merced, San Benito and Santa Cruz counties. We currently serve more than 418,000 members.

• Increases membership in the Alliance Medicare D-SNP program through direct sales and marketing of Alliance Medicare products to dual-eligible, Medicare/Medi-Cal recipients within assigned service area • Develops a sales network to generate leads and provide opportunities for outreach • Supports Medicare Sales Department activities and programs