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Join the Clean Energy RevolutionBecome a DistributionApparatus Supervisor at Southern California Edison (SCE) and build a better tomorrow. This is a critical leadership role within Distribution/Metro East Region and is responsible for keeping power generation and apparatus communications running safely and reliably, 24/7. This role is exciting because it blends hands-on technical oversight, and the challenge of supporting essential infrastructure that powers our distribution systems. The work directly impacts operational excellence, safety, and innovation—making every day dynamic and meaningful, while helping to power our planet, reduce carbon emissions and create cleaner air for everyone.&nbsp;As a DistributionApparatus Supervisor, your work will help power our planet, reduce carbon emissions and create cleaner air for everyone. Are you ready to take on the challenge to help us build the future?<h4>Responsibilities</h4><ul><li>Supervises multiple crews responsible for the distribution of apparatus pieces of equipment.</li><li>Creates and maintains a safety conscious work environment by leading and influencing others to follow Edison safety protocols and safe work practices.</li><li>Manages a highly specialized workforce.</li><li>Meets timelines and maintains good customer relations.</li><li>Reviews, implements, authorizes, validates, and tracks assigned work scopes and scope changes at the field level also in alignment with department and organizational goals.</li><li>Supervises programs and processes that affect the performance of the distribution power grid.</li><li>Provides leadership and oversight in the administration of Human Resources policies, and performance management of bargaining unit employees.</li><li>Provides safety leadership and direction for the elimination of injuries, accidents, and performance errors.</li><li>Provides representative subject matter expertise support to internal /external departments such as Grid Operations, Engineering, Distribution Automation, TS&amp;S, RPPM and DCM.</li><li>A material job duty of all positions within the Company is ensuring the protection of all its physical, ﬁnancial and cybersecurity assets, and properly accessing and managing private customer data, proprietary information, conﬁdential medical records, and other types of highly sensitive information and data with the highest standards of conduct and integrity.</li></ul><h4>Minimum Qualifications</h4><ul><li>One or more years of supervisory and/or team leadership experience.</li><li>Two or more years of distribution apparatus experience.</li><li>Possess a valid Class C Driver's License.</li></ul>Preferred Qualifications<ul><li>Expertise in major apparatus functions and system requirements including standards or construction and maintenance</li><li>Previous supervisory experience overseeing represented employees</li><li>Familiarity with industry standards including IEEE and IEC.</li><li>Experience with system studies and software revolving around apparatus technical software and construction</li><li>Strong analytical and problem-solving skills</li><li>Effective communication and leadership abilities to represent SCE at technical committees and coordinate with cross-functional teams and district personnel</li></ul>Additional Information <ul><li>This position’s work mode is on-site. The employee will report to an SCE facility or in the field location.&nbsp; Further details of this work mode will be discussed at the interview stage. The work mode can be changed based on business needs.</li><li>Visit our&nbsp;Candidate Resource page to get meaningful information related to benefits, perks, resources, testing information, hiring process, and more!</li><li>Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.&nbsp;</li><li>Position will require up to 80% traveling and being out in the field throughout the SCE service territory. </li><li>Relocation does not apply to this position.</li></ul>About Southern California EdisonThe people at SCE don't just keep the lights on. Our mission is so much bigger. We’re fueling the kind of innovation that’s changing an entire industry, and quite possibly the planet. Join us and create a future with cleaner energy, while providing our customers with the safety and reliability they demand. At SCE, you’ll have a chance to grow personally and professionally, making a real impact in Southern California and around the world.Southern California Edison is a proud Equal Opportunity Employer, including disability and protected veteran status.We are committed to ensuring that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodations at (833) 343-0727.

Southern California Edison

Distribution Apparatus Supervisor

The e-Commerce Sales Associate interacts with hundreds of customers – online, over the phone and in person – to help guide their vehicle purchase in our no-haggle sales environment. Responding to leads in a timely fashion, answering questions, providing information and helping guide customers effectively from phone and internet contact to an in-store experience while providing an exceptional customer experience is key.Sell with Confidence. Grow with AutoNation.AutoNation is redefining the car-buying experience—and we need driven, customer-focused professionals to help us lead the way. With nationwide inventory and a supportive team, you’ll have everything you need to succeed.Why You’ll Love Working Here:<ul><li>Competitive benefits</li><li>Career paths into finance, management, and beyond</li><li>A culture built on trust, transparency, and teamwork</li></ul>What We’re Looking For:<ul><li>Strong communication and interpersonal skills</li><li>A desire to help people and exceed expectations</li><li>Sales or customer service experience preferred</li></ul>Apply now and start building a career with purpose and potential.With your outstanding communication and listening skills, you’ll help our customers select their perfect vehicle, negotiate terms to ensure that payment options meet their lifestyles, budgets, and expectations and close the deal. Our e-Commerce Sales Associates provide an exceptional customer experience both before and after purchase, driving loyalty by following up to ensure customer satisfaction and helping transition customers to the Service department to support their ownership experience.<h2>What are the requirements for this job?</h2><ul><li>High school diploma or equivalent</li><li>Proven ability to provide an exceptional customer experience</li><li>Drive to set and achieve targeted goals</li><li>Prior sales experience, retail preferred</li><li>Demonstrated communication, consultative, interpersonal and organizational skills</li><li>The willingness to follow up with customers</li><li>Experience and desire to work with technology</li><li>Valid in-state driver’s license and an acceptable, safe driving record</li><li>Why should I come work for AutoNation?</li><li>You want to work for a car dealer that has a strong moral compass and treats all of its associates with respect</li></ul>This is a commission-based role with an estimated income of $4-12k/month.<h2>Exciting Benefits and Perks Await You:</h2><ul><li>Competitive compensation and 401k matching</li><li>Enjoy a healthy work-life balance with insurance plans (health, dental, vision) and maternity benefits.</li><li>Associate purchase and discount programs for new and pre-owned vehicles, services, parts, collision, accessories, and AutoGear</li><li>Access amazing deals and discounts through YouDecide, a website with offers from top providers and retailers</li><li>Join our DRVPNK mission to raise and donate millions of dollars to cancer research and treatment, partnering with cancer charities nationwide</li></ul>AutoNation is one of the largest automotive retailers in the United States, offering innovative products, exceptional services, and comprehensive solutions, empowering our customers to make the best decisions for their needs. With a network of dealerships nationwide strengthened by a recognized brand, we offer a wide variety of new and used vehicles, customer financing, parts, and provide expert maintenance and repair services. Through DRV PNK, we have raised over $40 million for cancer-related causes, demonstrating our commitment to making a positive difference in the lives of our Associates, Customers, and the communities we serve. &nbsp;AutoNation is committed to creating a diverse, equitable, and inclusive environment in our workplace and the services we provide. We welcome candidates from all backgrounds who are passionate about making a positive impact. Even if you do not meet every requirement, we encourage you to apply. Join our team and help us foster a culture of belonging while contributing to our revolutionary work in the automotive industry. We value innovation, teamwork, and a commitment to making a positive impact in the world.

AutoNation

Sales Associate-eCommerce/Phone at AutoNation CDJR Valencia

The e-Commerce Sales Associate interacts with hundreds of customers – online, over the phone and in person – to help guide their vehicle purchase in our no-haggle sales environment. Responding to leads in a timely fashion, answering questions, providing information and helping guide customers effectively from phone and internet contact to an in-store experience while providing an exceptional customer experience is key.Sell with Confidence. Grow with AutoNation.AutoNation is redefining the car-buying experience—and we need driven, customer-focused professionals to help us lead the way. With nationwide inventory and a supportive team, you’ll have everything you need to succeed.Why You’ll Love Working Here:<ul><li>Competitive benefits</li><li>Career paths into finance, management, and beyond</li><li>A culture built on trust, transparency, and teamwork</li></ul>What We’re Looking For:<ul><li>Strong communication and interpersonal skills</li><li>A desire to help people and exceed expectations</li><li>Sales or customer service experience preferred</li></ul>Apply now and start building a career with purpose and potential.With your outstanding communication and listening skills, you’ll help our customers select their perfect vehicle, negotiate terms to ensure that payment options meet their lifestyles, budgets, and expectations and close the deal. Our e-Commerce Sales Associates provide an exceptional customer experience both before and after purchase, driving loyalty by following up to ensure customer satisfaction and helping transition customers to the Service department to support their ownership experience.<h2>What are the requirements for this job?</h2><ul><li>High school diploma or equivalent</li><li>Proven ability to provide an exceptional customer experience</li><li>Drive to set and achieve targeted goals</li><li>Prior sales experience, retail preferred</li><li>Demonstrated communication, consultative, interpersonal and organizational skills</li><li>The willingness to follow up with customers</li><li>Experience and desire to work with technology</li><li>Valid in-state driver’s license and an acceptable, safe driving record</li><li>Why should I come work for AutoNation?</li><li>You want to work for a car dealer that has a strong moral compass and treats all of its associates with respect</li></ul>This is a commissioned-based position, ranging $3k to $10k a month.<h2>Exciting Benefits and Perks Await You:</h2><ul><li>Competitive compensation and 401k matching</li><li>Enjoy a healthy work-life balance with insurance plans (health, dental, vision) and maternity benefits.</li><li>Associate purchase and discount programs for new and pre-owned vehicles, services, parts, collision, accessories, and AutoGear</li><li>Access amazing deals and discounts through YouDecide, a website with offers from top providers and retailers</li><li>Join our DRVPNK mission to raise and donate millions of dollars to cancer research and treatment, partnering with cancer charities nationwide</li></ul>AutoNation is one of the largest automotive retailers in the United States, offering innovative products, exceptional services, and comprehensive solutions, empowering our customers to make the best decisions for their needs. With a network of dealerships nationwide strengthened by a recognized brand, we offer a wide variety of new and used vehicles, customer financing, parts, and provide expert maintenance and repair services. Through DRV PNK, we have raised over $40 million for cancer-related causes, demonstrating our commitment to making a positive difference in the lives of our Associates, Customers, and the communities we serve. &nbsp;AutoNation is committed to creating a diverse, equitable, and inclusive environment in our workplace and the services we provide. We welcome candidates from all backgrounds who are passionate about making a positive impact. Even if you do not meet every requirement, we encourage you to apply. Join our team and help us foster a culture of belonging while contributing to our revolutionary work in the automotive industry. We value innovation, teamwork, and a commitment to making a positive impact in the world.

Sales Associate - AutoNation Toyota Buena Park

Sales Associate eComPhone - CDJR Valencia

Salary Range:&nbsp;&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Manager, Category Management and Procurement manages and leads the development and execution of multi-year category strategies and implementation of the overall category management and procurement processes for multiple categories and commodities. This position manages continuous improvement and governance of the L.A. Care source-to-pay process. The Manager works closely with key stakeholders and cross-functional teams in developing and executing category plans, strategic sourcing events, supplier performance management (scorecards/quarterly business reviews).The Manager is an expert on all category management, procurement, and relationship management requirements and processes.&nbsp; The position leads and provides consultation to other cross-functional teams with executing cost reduction and related activities across the enterprise. The Manager ensures that the team's collective efforts deliver measurable value (savings, cost avoidance, risk reduction, and service improvements), reduce request for proposal (RFP) and contract cycle time, and increase customer service in support of optimizing L.A. Care operations. This position interfaces with internal and external stakeholders.&nbsp;This position manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.&nbsp; The Manager also stewards adherence to procurement policy, contracting standards, and audit readiness across assigned categories. Participates and makes recommendation on the department's strategic planning and/or long-term decision-making.<h4>Duties</h4>Manages and leads the overall category management and procurement process to ensure high-value execution and integrity of all vendor relationships, pricing and contracts within L.A. Care source-to-pay. Oversees the development and execution of category strategies that align with organizational priorities and deliver measurable savings, efficiency, and compliance. Leverages and optimizes source-to-pay (S2P) systems to improve transparency, accuracy, and cycle time. Ensures vendor data integrity, pricing accuracy, and timely contract execution. Develops requirements, reports, and staff training that reinforce continuous improvement and effective use of procurement systems.Manage and develops staff, including, but not limited to monitoring of day-to-day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others. Ensures staff are proficient in category management methodologies, procurement policies, and S2P tools. Provides guidance, feedback, and escalation support to enable effective decision-making and issue resolution. Responsible for reporting, budgeting, and policy implementation.Manages complex, cross-functional sourcing and contracting projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. Leads Vendor Selection Process/Request for x (RFxs) and negotiations on select high value vendor contracts from cross-functional teams and provides consultative expertise to the team on other vendor RFxs. Ensures documentation, evaluation criteria and award decisions are compliant, transparent and aligned with L.A. Care standards.<h4>Duties Continued</h4>Plans, implements and refines systems and procedures to maximize operating efficiency and achieve strategic priorities.<h4>Acts as a subject matter expert (SME) for cross-functional teams on proper category management and procurement execution that balances risks and flexibility.&nbsp; Ensures end-to-end source-to-pay process complies to L.A. Care policies while incorporating best practice for effectiveness, efficiency, and better customer service. Implements end-to-end category management and procurement procedures that are compliant to L.A. Care policies and meet L.A. Care's objectives. Ensures category management and procurement procedures and training materials complement procurement processes.&nbsp; Drives continuous process improvement, automation and adoption of best-practice sourcing governance.</h4><h4>Partners with internal departments to develop effective contract processes, tools, and standard procedures while leveraging the contract management system to its fully extent possible. Responsible for safeguarding the acceptable contract clauses, language, templates, and tools pre-approved by the legal team. Collaborates with key stakeholders to manage risk, maintain compliance and improve contract quality and turnaround time.</h4><h4>Leads and facilitates formal meetings with senior internal staff in developing strategic and tactical plans for category management, vendor relationship management, savings opportunities and/or RFx/contracting strategies that allow L.A. Care to function more effectively. Performs vendor contract inventory analysis and reporting, including contracts expirations, spend and compliance data, for review.&nbsp; These insights inform category plans, sourcing pipelines and vendor consolidation opportunities to strengthen vendor performance and ensure ongoing contract compliance. Performs other duties as assigned.</h4><h4>Education Required</h4>Bachelor's Degree in Business or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Business or Related Field<h4>Experience</h4>Required:At least 6 years of relevant experience managing the full contract lifecycle for service-related categories and commodities.At least 4 years of experience in leading, supervising, and/ or managing staff, whether directly or indirectly.Experience drafting, negotiating, red lining, finalizing and managing complex supplier agreements for a wide variety of goods and services.<h4>Skills</h4>Required:Strong legal and business acumen with demonstrated ability to manage complex negotiations and relationships.&nbsp;Excellent written and verbal communication and presentation skills to secure most favorable terms, prices and/services levels and contract terms.&nbsp;Ability to provide direction to team members to execute category management, procurement, and contract efforts with outside vendors.&nbsp;Ability to negotiate and manage relationships and contracts with outside vendors that are in the best interests of L.A. Care.&nbsp;Tactful, diplomatic in implementing new processes, procedures, and systems across L.A. Care and ability to convince staff and management why changes are needed. Skilled in driving and integrating organizational change across all levels.&nbsp;Must be proactive, resourceful, and able to find alternative solutions to deliver results.&nbsp;Demonstrated ability to communicate, problem solve, and work effectively with business, procurement and legal professionals.&nbsp;Ability to be consultative to internal stakeholders on developing the best category management and strategic sourcing (including contract) options.&nbsp;Excellent organizational skills with the ability to manage multiple projects.&nbsp;Strong internal stakeholder management skills: capacity to listen, build trusting relationships in all levels of the organization, understand and capture stakeholder's needs and deliver effective solutions.&nbsp;Good knowledge of legal environment related to purchasing contracts and framework agreements.&nbsp;Strong analytical skills, with keen understanding of relevant cost drivers.&nbsp;Demonstrated ability to select, manage, develop and coach others.&nbsp;Persuasion Skills: Effective negotiator who exhibits high levels of personal integrity and honesty. Skills in planning and coordinating vendor visits and negotiations, and comprehensive knowledge of market conditions. Understanding of the flow and accounting requirements to facilitate document flow and efficiency. Ability to enforce policy compliance.&nbsp;Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members.&nbsp;Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision.&nbsp;Skilled in mediating disputes and resolving conflicts in a fair and constructive manner. Must have a deep understanding of financial principles.&nbsp;Ability and excellent knowledge in developing and managing budgets, forecasting future financial outcomes, and making informed decisions about resource allocation.&nbsp;Demonstrated ability to make informed decisions.&nbsp;Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges. Strong ability and knowledge to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Financial Impact: Effective vendor contract negotiation will have a high financial impact and influence because of negotiation of pricing and contract terms.Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Relationship Manager, Performance Management, Customer Service, Human Resources

L.A. Care Health Plan

Manager, Category Management and Procurement

Salary Range:&nbsp;&nbsp;$171,925.00&nbsp;(Min.) -&nbsp;$232,100.00&nbsp;(Mid.) -&nbsp;$292,274.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Senior Director, Core Administrative Operations is responsible for leading and optimizing L.A. Care’s core administrative functions, including Claims Administration, Payment Integrity, Configuration, Electronic Dara Interchange (EDI) and Quality Assurance. This leader ensures standardized, efficient, accurate, and compliant administrative operations that support high-quality service to providers, members, and internal business partners.Steers top-level decision-making and implement initiatives that drive organization's forward. This role drives modernization, operational maturity, and continuous improvement across all core administrative operations, grounded in clear performance expectations, strong governance, and measurable outcomes. The Senior Director collaborates closely with cross functional teams to ensure effective alignment, operational readiness, and sustained performance The Senior Director will oversee a diverse team, ensuring talent development, performance management, and a culture of accountability and operational excellence.This position is responsible for directing all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.&nbsp; Develops strategic plans, drives change and influences critical business outcomes.<h4>Duties</h4>Translates strategy into disciplined operational execution. &nbsp;Sets clear expectations, drives cross-functional alignment, and ensures that teams have the tools, data, and governance needed to operate effectively. Collaborates across multiple administrative functions, ensuring workflows, technical changes, performance indicators, and regulatory requirements are understood, synchronized, and executed consistently. Anticipates operational challenges, removes barriers, and strengthens end-to-end processes. &nbsp;Collaborates, plans, proactively problem-solves, leads with transparency, accountability, and focuses on continuous improvement. &nbsp;Elevates operational reliability and positions the organization for sustained success as systems, products, and regulatory standards evolve.Leads strategy, operations, and modernization across service areas accuracy, efficiency, and strong control environments. Establishes and manages operational goals, key performance indicators (KPIs)/objectives and key results (OKRs), dashboards, and other metrics to transparently drive consistent performance and compliance.Develops and implements standardized workflows, governance structures, and operating procedures.Fosters a culture of proactive issue identification, cross-functional communication, accountability, transparency, and continuous operational improvement.Directs EDI operations supporting claims submissions, remittance transactions, provider and member exchanges, and other electronic transactions.&nbsp; Drives automation, data accuracy, and improved electronic submission performance. Oversees monitoring and timely resolution of technical issues, rejections, and systemic defects.Ensures high-quality adjudication with strong accuracy, first-pass rates, correct benefit application, and compliance with DHCS, DMHC, CMS, Covered California, and NCQA requirement. Oversees configuration of benefits, reimbursement logic, pricing methodologies, and adjudication controls.<h4>Duties Continued</h4>Collaborates with key stakeholders on prioritization, execution, and validation of configuration updates, system enhancements, and benefit launches.Leads strategy and operations related to pre-pay controls, cost-avoidance, post-pay recovery, clinical editing, coordination of benefits (COB), overpayments, and third-party liability (TPL)/subrogation.&nbsp; Partners with cross functional teams to support fraud mitigation and compliance with state and federal requirements.&nbsp; Improves financial accuracy and reduces inappropriate payments through robust controls and audit-ready processes.Oversees QA programs across all Core Administrative Operations to ensure ongoing accuracy and compliance.&nbsp; Strengthens control environments through audits, desktop and other standard operating procedures, and performance monitoring.&nbsp; Partners with Compliance, Internal Audit, and Enterprise Risk Management on CAPs, audit responses, remediation plans, and sustainability efforts.Oversees the performance of operational vendors in assigned areas. Ensures compliance with service level agreements (SLAs), audit standards, quality expectations, and contractual obligations. Evaluates vendor performance and ensures the implementation of improvements.Develops goals, objectives and actions plans for assigned staff which includes full management responsibility for the hiring, performance reviews, salary reviews and disciplinary matters for direct reporting employees.Manages budgets and resources effectively. Conducts strategic planning to utilize resources in order to meet current and future departmental and Enterprise-wide goals.&nbsp; Identifies and actualizes enhancements to support company vision. &nbsp;Identifies and drives change initiatives.Collaborates with cross-functional teams to achieve common goals. &nbsp;Leads discussions on policy operationalization and oversees key policy perspective sharing. &nbsp;Represents the company or organization in external interactions. &nbsp;Develops and maintains relationships with key stakeholders.Develops and implements communication strategies.Performs other duties as assigned.<h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Business Administration or Related Field<h4>Experience</h4>Required:At least 9 years of progressively responsible experience leading large operational teams and multi-functional departments in managed care operations, including Claims Administration, Payment Integrity, Configuration, or similar functionsAt least 8 years of management/supervisory experience.At least 5 years of experience with Payment Integrity operations.At least 5 years of experience with claims system configuration, technical changes, and operational readiness for products, benefits, and system updates.Demonstrated successful experience improving operational accuracy, reducing inappropriate payments, and driving regulatory compliance.At least 5 years of experience supporting regulatory audits.Preferred:Experience in government-sponsored programs and large regional plans.Experience with vendor management.<h4>Skills</h4>Required:Strong interpersonal leadership skills and an ability to motivate and develop talent while driving accountability.Expert knowledge of managed care administrative operations. Strong strategic, analytical, and financial skills, including the ability to interpret trends, assess risk, and evaluate cost-avoidance opportunities.Deep understanding of regulatory requirements for Medicaid (Medi-Cal), Medicare, Marketplace, and commercial lines of business.Proven ability to lead in complex, high-volume, highly regulated environments with competing priorities.Exceptional communication and stakeholder management skills, with the ability to translate complex concepts into actionable plans. Exceptional leadership skills and abilities, with demonstrated ability to manage, mentor, and develop multi-level teams.Ability to design and implement standardized processes, governance models, and operational controls.Strong skills with claims platforms and analytics/reporting tools.Proficient with Microsoft Office and data/reporting tools.High level of organization, planning, prioritization and attention to detail.Demonstrated ability to think long-term and develop strategies that align with the overall goals of the organization.Demonstrated ability to make sound and timely decisions.Demonstrated ability to adapt to changing situations and adjust strategies accordinglyDemonstrated ability to adapt to a fast-paced and evolving environment and to lead others through change.Excellent interpersonal skills for building relationships, fostering teamwork, and creating a positive work environmentExcellent ability and knowledge in analyzing data, identifying problems, and making informed decisions, often in complex or ambiguous situations.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4>Lean Six Sigma Green BeltLean Six Sigma Black Belt<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Internal Audit, Claims, Medicaid, Medicare, Risk Management, Finance, Insurance, Healthcare

Senior Director, Core Administrative Operations

Salary Range:&nbsp;&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Senior Manager, Clinical and Regulatory Operations, is responsible for leading clinical case operations, regulatory interpretation, and clinical decision stewardship across all grievance, appeal, and State Fair Hearing cases. This position ensures that clinical and non-clinical case handling meets medical necessity standards, regulatory requirements, internal policy expectations, and quality-of-care obligations across all product lines, including Medi-Cal, Medicare, Marketplace, and delegated entities.The Senior Manager oversees clinical operations teams responsible for medical necessity reviews, clinical grievances and appeals, Quality of Care (QOC) referrals, clinician coordination, clinical documentation quality, and regulatory interpretation. The role ensures strong collaboration with Utilization Management, the UM Medical Director, physician reviewers, Compliance, Member Services, Provider Network Management, claims teams, and the Center of Quality &amp; Excellence to support compliant, timely, and high-quality case handling.The Senior Manager manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.&nbsp; Responsible for driving performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.&nbsp; Oversees the development, implementation, administration, and maintenance of the department's programs, policies, and procedures. Responsible for driving management and performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.Collaborate closely with executive/ senior management to establish goals that align with the company’s mission and vision.<h4>Duties</h4>Oversees end-to-end clinical case handling, including clinical grievances, clinical appeals, medical necessity review coordination, and clinical case triage and ensures consistent application of evidence-based guidelines, clinical criteria, and regulatory standards in all clinical decisions. Partners with the clinical leadership to ensure clinical decision accuracy and appropriateness. Translates clinical guidelines, regulatory requirements, and service standards into operational workflows that ensure accurate, timely, and clinically sound case handling. Ensures clinical documentation is accurate, complete, defensible, and compliant with regulatory expectations.Oversees Quality of Care (QOC) case identification, referral, coordination, and documentation ensuring timely escalation and coordination of complex or medically nuanced grievance and appeal cases.Strengthens the clinical and regulatory integrity of Appeals &amp; Grievances (A&amp;G) operations by guiding staff in the application of medical necessity criteria, ensuring documentation quality, and providing expert regulatory interpretation. Interprets and applies Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), and internal policy requirements related to grievance and appeal processes, ensuring operations maintain regulatory alignment. Serves as a subject-matter expert for regulatory interpretation, providing guidance to operational staff and leadership. Reviews, interprets, and implements regulatory updates that impact clinical or operational grievance and appeal workflows. Partners with Compliance and Legal to resolve regulatory inquiries related to clinical and operational case-handling requirements. Supports creation and revision of clinical and operational policies, SOPs, templates, letters, and decision-support tools.Partners with cross-functional stakeholders to ensure proper handling of clinical and non-clinical cases. Coordinates cross-functional involvement in complex cases, including providers, delegates, plan partners, and medical directors. Supports operational teams in resolving regulatory or clinical issues that arise during case handling.Oversees training and competency development for clinical operations staff, ensuring consistent understanding of medical necessity criteria, regulatory requirements, and decision-making standards. Identifies opportunities to enhance staff capability, accuracy, and regulatory alignment across clinical case-handling processes.Oversees clinical case reporting and trend analysis, identifying patterns in clinical appeals, grievances, and QOC findings. Provides insights to leadership related to clinical drivers of grievances and appeals, opportunities for operational improvements, and service or quality risks.Manages staff and the day-to-day activities in the department. Participates in the department budgeting process.&nbsp; Responsible for scheduling, training, performance, corrective actions, mentoring, and developing of the team(s). Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals. Mentors and develops staff, building technical and critical thinking skills across the team.Implements and provides guidance to the departmental and organizational processes and policies and works with senior and/ or executive management to define, prioritize, and develop projects and programs.Responsible for Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.Responsible for overseeing and managing the budgets of their respective departments.<h4>Duties Continued</h4>Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.&nbsp; Ensures strong clinical judgment, regulatory understanding, and documentation discipline across the team.Builds a culture of rigor, transparency, analytical curiosity, proactive issue identification, cross-functional communication, accountability, transparency, and continuous operational improvement.Perform other duties as assigned.<h4>Education Required</h4>Bachelor's Degree in Nursing or Related Field<h4>Education Preferred</h4>Master's Degree in Business Administration or Related Field<h4>Experience</h4>Required:At least 6 years of experience working in managed care operations, quality assurance, audit readiness, compliance, or related regulatory roles.At least 5 years of experience in leading, supervising and/or managing staff.Experience in Medicaid, Medicare, and Commercial managed care lines of business.Demonstrated experience overseeing quality assurance programs, internal controls, or audit readiness functions within a health plan or similar setting.Strong experience with DHCS, DMHC, CMS, and NCQA requirements related to grievances, appeals, quality-of-care processes, and audit expectations.Experience developing and managing corrective action plans and driving sustainable remediation.Experience collaborating with delegated entities, plan partners, or subcontracted networks.Experience leading teams, projects, initiatives, or cross-functional groups.Preferred:Experience with analytic dashboards and visualization tools (Power BI, Tableau).<h4>Skills</h4>Required:Proven ability to lead universe submissions, mock audits, and regulatory audit responses.Expert knowledge of regulatory requirements, audit processes, and quality assurance practices in managed care.Strong analytical, problem-solving, and critical thinking skills, including ability to translate trends into corrective actions.Ability to design, implement, and sustain standardized processes and internal control structures.Exceptional written and verbal communication skills, including executive communication and the ability to translate trends and other findings into actionable recommendations.Proficiency with Microsoft Office, case management systems, and reporting tools.Strong people skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members.Strong attention to detail and ability to manage multiple priorities and tight deadlines.Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision.Skilled in mediating disputes and resolving conflicts in a fair and constructive manner.Must have a deep understanding of financial principles.Ability and exceptional knowledge in developing and managing budgets, forecasting future financial outcomes, and making informed decisions about resource allocation.Demonstrated ability to make informed decisions.Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges.Strong ability and knowledge to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals.<h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California License<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>This position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical situations and work on-call.This position requires handling various caseloads and flexibility to adapt to changing priorities which may include but not limited to redistributed work assignments, team projects, and other priorities as assigned.Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Nursing, Registered Nurse, Medicare, Medicaid, Medical Research, Healthcare

Senior Manager, Clinical and Regulatory Operations

Salary Range:&nbsp;&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. <h4>Job Summary</h4>The Senior Manager, Electronic Data Interchange (EDI) &amp; Data Operations is responsible for leading and optimizing the day-to-day operational, analytical, and technical functions that support electronic data exchange, authorization data ingestion, accumulator management, and Explanation of Benefits (EOB) processing for L.A. Care. This includes operational oversight of all Health Insurance Portability and Accountability Act (HIPAA) standard and proprietary EDI transactions, delegated and internal authorization data loads, accumulator workflows, and the operational components of EOB generation and remediation.The Senior Manager oversees a team who manage file intake, data validation, routing, reconciliation, testing, and issue resolution across the enterprise. This position ensures that all electronic and paper-to-electronic data supporting claims and administrative operations is accurate, timely, and compliant with regulatory, contractual, and quality expectations.This position plays a critical leadership role in enhancing upstream controls, reducing rework, improving automation, supporting system changes, and driving continuous improvement in data operations.Manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct reports.&nbsp; Responsible for driving performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.&nbsp; Oversees the development, implementation, administration, and maintenance of the department's programs, policies, and procedures. Responsible for driving management and performance to ensure that the team can lead high-level decisions that impact on the success of L.A. Care.Collaborate closely with executive/ senior management to establish goals that align with the company’s mission and vision.<h4>Duties</h4>Strengthens the reliability, accuracy, and efficiency of all electronic data processes that support claims operations, ensuring data flows through systems as intended, issues are rapidly identified and remediated, and upstream controls are continuously enhanced. Helps drive predictable outcomes, improve payment accuracy, and maintain regulatory readiness across the data ecosystem.Manages end-to-end operational oversight of all inbound and outbound HIPAA-standard and proprietary EDI transactions (837, 835, 270/271, 276/277, 834, 278). Ensures timely, accurate, and compliant processing of electronic claims, encounters, eligibility updates, and related administrative data.Oversees transaction monitoring, exceptions, error queues, and data rejects; ensures prompt triage and resolution. Provides oversight of requirements documentation, including business and functional requirements (BRDs/FRDs), workflow mapping, and data specifications that support operational effectiveness.Plans and implements systems and procedures to maximize operating efficiency and achieve strategic priorities.&nbsp;Leads oversight of delegated Electronic Load of Delegated Authorizations (ELDA) and internal clinical authorization data loads into QNXT. Ensures authorization data is timely, complete, reconciled, and supportive of accurate claims adjudication.Monitors authorization load success rates and partners with upstream teams to resolve recurring issues. Guides enhancements that reduce manual lookup burden for claims and increase automation.Manages operational components of the Member Out-of-Pocket (MOOP) accumulator workflow, including reconciliation, error correction, escalation management, and member remediation.Ensures accumulator data is accurate across intake systems, accumulator databases, QNXT, and output files.Provides reporting and trending on accumulator performance, error patterns, and upstream causes.Shares responsibility with the Director, EDI for operational oversight of EOB generation, validation, and data flow.Ensures EOB output files reflect accurate benefit application, share of cost, accumulation, claim decisions, and meets regulatory requirements. Troubleshoots and resolves EOB-related issues, including cost-share miscalculations, missing data, formatting discrepancies, and system defects. Supports testing of EOB templates, logic updates, and system enhancements that impact EOB accuracy and delivery.Leads complex root cause analyses for issues impacting claims data, authorizations, accumulators, or EOBs.<h4>Duties Continued</h4>Coordinates remediation efforts with cross-functional departments. Implements and provides guidance to the departmental and organizational processes and policies and works with senior and/ or executive management to define, prioritize, and develop projects and programs.Ensures corrective actions are documented, validated, and monitored to prevent recurrence. Identifies systemic issues and recommends upstream solutions to strengthen operational controls and improve accuracy.Responsible for Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions. Manages complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval. Leads process and workflow redesign efforts to increase automation, reduce manual work, and improve overall data quality.Oversees User Acceptance Testing (UAT) planning, test case creation, execution, and validation for system changes affecting EDI, authorization data, accumulators, and EOBs.Ensures strong quality gates are consistently applied before production releases.Works closely with the Director, EDI to prioritize enhancements and support operational readiness for system changes.Serves as an operational liaison to cross-functional departments and delegated entities.Communicates system availability, planned changes, incident statuses, and file processing updates clearly and consistently.Supports internal and external partners with non-standard data requests, testing analysis, and troubleshooting.Manages staff and the day-to-day activities in the department. Participates in the department budgeting process. Responsible for scheduling, training, performance, corrective actions, mentoring, and developing of the team(s). Foster and promote a culture of transparency, continuous improvement, accountability, and shared ownership of enterprise goals. Mentors and develops staff, building technical and critical thinking skills across the team. Responsible for overseeing and managing the budgets of their respective departments.Maintains a culture of rigor, transparency, analytical curiosity, proactive issue identification, cross-functional communication, accountability, and continuous operational improvement.Perform other duties as assigned.&nbsp;<h4>Education Required</h4>Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Master's Degree in Business Administration or Related Field<h4>Experience</h4>Required:At least 6 years of experience working with healthcare data, EDI transactions, claims data operations, or managed-care administrative systems.At least 5years of experience in leading, supervising and/or managing staff.Experience with system integrations, data migrations, or large-scale technical implementations.Demonstrated experience leading complex issue resolution and root cause analysis efforts.Experience leading teams, projects, initiatives, or cross-functional groupsPreferred:Experience developing test cases, leading UAT, or supporting system configuration changes.Experience with commercial health plan operations or delegated partner management.<h4>Skills</h4>Required:Strong knowledge of HIPAA-standard EDI transactions and healthcare data structures.Knowledge of MOOP accumulators, authorization workflows, and EOB data flows.Familiarity with claims adjudication rules, cost-share logic, and benefit application.Proficiency in SQL, Access, Excel, and related reporting or analysis tools.Ability to interpret and produce BRDs, FRDs, process flows, and technical documentation.Strong analytical, problem-solving, and system-thinking skills.Strong interpersonal skills for building relationships, fostering teamwork, and creating a positive work environment. Ability to guide and support team members.Excellent attention to detail and ability to manage multiple priorities and tight deadlines.Excellent ability to set clear goals, develop strategic plans to achieve those goals, and inspire others to work towards a shared vision.Skilled in mediating disputes and resolving conflicts in a fair and constructive manner.Ability to develop and manage budgets, forecast future financial outcomes, and make informed decisions about resource allocation.Demonstrated ability to make informed decisions.Excellent verbal, written communication, and presentation skills.Deep understanding of the industry, market dynamics, and organizational operations to identify opportunities and navigate challenges.Strong ability to analyze market trends, anticipate future changes, and develop long-term strategies that align with the company's goals.Preferred:Working knowledge of relational databases, system interfaces, or data transformation logic.Experience with delegated entity data submissions or clearinghouse integrations.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul> Nearest Major Market: Los Angeles Job Segment: Claims, Insurance

109 Procurement / Operations Jobs in Alhambra, CA, USA