Teams at Central California Alliance for Health

Manages individualized pediatric care plans for complex case management members, coordinating with families, providers, agencies, and internal teams. Educates stakeholders, evaluates medical records and healthcare data, applies clinical and regulatory guidelines, and supports quality improvement initiatives. Requires a California RN license, nursing education, pediatric patient-care experience, and case management experience. This is a full-time temporary hybrid position.

Lead and direct the Application Services Department, overseeing application lifecycle management, enterprise software implementations, architecture, staff supervision, and operationalizing strategic vision for enterprise applications to improve efficiency, compliance, and member care.

Designs and validates managed care payer models, performs financial and scenario analysis to evaluate payer reimbursement methodologies, and collaborates with internal and external stakeholders to achieve payer reimbursement objectives.