CalOptima Health is seeking a highly motivvresponsible for overseeing the execution and leading the implementation of member outreach, acquisition and retention strategies and tactics. The incumbent will develop and maintain strong relationships between CalOptima Health, current and potential members, employed sales and marketing team, PACE marketing and enrollment team, external Field Marketing Organizations (FMO) or external broker agencies including their independent brokers and contracted health networks and providers throughout CalOptima Health’s service area. The incumbent will function as the business over for operations and systems implementation related to sales channels, including broker portals and interfaces. The incumbent will be responsible for increasing the visibility of CalOptima Health’s competitive lines of business through marketing, outreach and education. The incumbent will be responsible for driving membership growth through employed and independent agents to increase enrollment into CalOptima Health’s competitive lines of business. 

Position Information:

• Department: OneCare Sales & Marketing
• Salary Grade: 320 - $170,772 - $273,234 ($82.10 - $131.3625)
• Work Arrangement: Partial Telework 
  
  **This position is eligible for telework in California.** 

Duties & Responsibilities:

• 45% - Leadership Functions
  • Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  • Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the marketing and sales department.
  • Provides direction and accountability, in a dotted line capacity, to the Manager, PACE Outreach and Education and the Senior Director of Strategic Development overseeing Covered California.
  • Hires and trains department managers and staff, sets monthly or quarterly goals based on direction from the executive director and leadership.
  • Directs and oversee the participation of the OneCare, PACE and Covered California sales agents at outreach and retention events and activities conducted by the respective outreach and education program managers and staff.
  • Onboards and manages relationships and production of new enrollment by FMO and/or broker agencies.
  • Collaborates with executive director, senior director, strategic development and other lines of business leadership and staff in all relevant internal departments to share information and promote a positive and collaborative business relationships with vendors and providers.
  • Partners with the Provider Relations department to develop and conduct provider communications and updates.
  • Partners with Health Network Provider Relations department on outreach and updates the contracted networks regarding enrollment strategies and tactics.
  • Provides subject matter expertise and strategic advice regarding the development of competitive benefit plans for all CalOptima Health competitive lines of business.
    
    
• 50% - Program Oversight
  • Sets monthly and/or quarterly goals from each FMO or broker agency aligned with direction from the executive director, senior director, strategic development and CalOptima Health leadership.
  • Plans and hosts weekly, monthly and/or quarterly joint operation meetings with each contracted FMO and/or broker agencies.
  • Oversees the development and content for annual training, certification or re-certification of employed and independent agents.
  • Develops and oversees an agent/broker customer service support function.
  • Manages the updates of content for CalOptima Health’s Agency and Agent Manuals.
  • Directs and collaborates closely with internal departments to maintain CalOptima Health’s sales agent portal, including maximizing automation of broker support systems and services.
  • Collaborates with the Communications department and competitive line of business leaders in the development of marketing and advertising campaigns.
  • Monitors OneCare, PACE and Covered California programs member/participant retention rates, identifies root causes of voluntary disenrollment trends and develops strategies and tactics for maximizing retention and positive member/participant experience and satisfaction.
  • Ensures compliance with all Center for Medicare & Medicaid Services (CMS), state Medi-Cal and Department of Managed Health Care (DMHC) marketing, sales and enrollment regulations.
  • Develops and manages the annual departmental budget.
  • Develop policies, procedures and standards for all department activities and member enrollment processes.
  • Oversee the maintenance of all department records and reports.
    
    
• 5% - Completes other projects and duties as assigned. 

Minimum Qualifications:

• Bachelor’s degree PLUS 7 years of experience in management position working with the needs of seniors and persons with disabilities in marketing, sales, outreach or enrollment required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
  
• 4 years of progressive leadership experience, including direct supervision of staff required.
  
• Health maintenance organization (HMO), Medi-Cal/Medicaid, Medicare and individual market insurance products or Covered California experience required.
  
• Driver’s license and vehicle or other approved means of transportation and an acceptable driving record will be required for work away from the primary office 50% of the time or more.
  

Preferred Qualifications:

• Master’s degree.

Required Licensure / Certifications:

• n/a

Knowledge & Abilities:

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.  
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):

• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Work Environment:

If located at the 500, 505 Building or a remote work location:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• There are no harmful environmental conditions present for this job.
• The noise level in this work environment is usually moderate.

If located at PACE:

• Work is typically indoors in a clinical setting serving the frail and elderly.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

If located in the Community:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. 
• Employee will occasionally work outdoors in varied temperatures.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

About CalOptima Health:
CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto — "Better. Together.” — is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community’s health.  We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring.  CalOptima Health has been recognized as one of Orange County’s best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! 

About our Benefits & Wellness options:
At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options.   For more information, please click on the 2025 CalOptima Health Benefits Guide regarding our comprehensive benefits and wellness package.

IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 20, 2025 at 9:00 PM (PST).  Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. 

The selection process may include, but is not limited to, a skills assessment, phone screen and interview.

The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening).  Internal CalOptima Health applicants should apply through InfoNet.

Communication regarding your application will be sent to the email address listed on your application.  Please check your email, including your SPAM folder, regularly throughout the recruitment process.  You can also visit your candidate portal to receive the most up to date status of your application.

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. 

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.