Director, Claims Administration (Director II)
CalOptimaHighlight
Summary
About the Role
About You
- Bachelor's degree in business administration or a related field.
- 7 years of experience in claims administration.
- 5 years of progressive leadership experience, including direct supervision of staff.
- Master's degree.
- Experience managing claims for a large health plan.
- Experience with HMO, Medi-Cal/Medicaid, Medicare, and commercial insurance.
Benefits
- Competitive compensation with a salary range of $181k–$290k.
- Comprehensive benefits package including CalPERS pension program.
- Generous PTO program and flexible scheduling.
- Tuition reimbursement and professional development opportunities.
CalOptima Health is a county organized health system that administers health insurance programs for low-income children, adults, seniors and people with disabilities in Orange County. As Orange County’s largest health insurer, we provide coverage through four major programs. - Medi-Cal (California's Medicaid Program) for low-income children, adults, seniors and people with disabilities - OneCare (HMO SNP) (a Medicare Advantage Special Needs Plan) for low-income seniors and people with disabilities who qualify for both Medicare and Medi-Cal - PACE (Program of All-Inclusive Care for the Elderly) for older adults, providing comprehensive health services through the CalOptima PACE center - OneCare Connect Cal MediConnect Plan (Medicare-Medicaid Plan) for people who qualify for both Medicare and Medi-Cal, combining Medicare and Medi-Cal benefits, adding supplemental benefits for vision, transportation and dental services, and providing comprehensive care coordination “Better. Together.” is our motto, but it’s also our philosophy. We believe that by working together, we can make things better – for our members and community.