Iehp Jobs in Usa

What you can expect!
Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!
Reporting to the Vice President of Health Services, the Senior Medical Director Policy & Outcomes (Sr. Medical Director - P&O) is responsible for the strategic oversight of IEHP Medical Policies and clinical leadership around member health outcomes. The Sr. Medical Director - P&O oversees the day-to-day operations as it relates to developing, executing, leading and updating guidelines, policies, clinical pathways, and communications enabling effective health outcomes, as well as effective health plan performance as per DHCS, DMHC, CMS, and CCA clinical requirements. This leader serves as the accountable medical leader for clinical activities related to key activities including quality management, grievance and appeals, delegation oversight, and population health management. The Sr. Medical Director - P&O also works in partnership with the appropriate cross functional departments to monitor the impact of policy outcomes through regular reporting, metrics, initiatives, and other improvement activities. This position is responsible for leading regulatory audits for all its relevant domains.
Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.
Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• Hybrid schedule
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance
  

Education & Requirements

• Seven (7) years of post-residency experience in a recognized medical specialty or practice, which must have included at least (3) years of medical administrative experience required
• Minimum of five (5) years of managed care or health plan leadership experience with proven track record of leading high performing physician teams
• Experience working with clinical practice guidelines and evidenced based criteria sets
• Has exposure to working with regulatory agencies
• Medical Director for an IPA, medical group, or CA HMO highly desirable
• Medical specialty/practice experience preferably in the state of California
• Doctorate of Medicine from an accredited institution required
• Certification by one (1) of the American Specialty Boards required
• Completion of an accredited residency program required. Possession of an active, unrestricted, and unencumbered Physician’s and Surgeon’s Certificate issued by the State of California required
  • A physician certified in a state other than California may be employed prior to receipt of California certification provided that an application for a California physician and surgeon’s certificate is filed in the state of California prior to date of appointment.
    

Key Qualifications

• Valid California Driver’s License preferred
• Possesses in depth comprehensive knowledge of:
  • Managed Care principles
  • Administrative practices and procedures (including but not limited to: credentialing and risk management, rules regulations, policies, and standards related to managed care)
  • Principles of effective supervision and organization; methods, techniques, practices, principles, and literature in the broad field of medical sciences
  • The principles of medical practice in a variety of settings (inpatient, outpatient, subacute, etc)
  • Familiarity with local healthcare organizations and/or local practice experience is preferred
• Highly Organized, Effective Communication Skills, Microcomputer applications such as Microsoft Word, Excel, and Access. Proven execution skills
• Assertive communicator
• Demonstrate effective leadership of other physicians and clinical staff
• A track record of leading with accountability is required
• Travel within California
  

Start your journey towards a thriving future with IEHP and apply TODAY!
Pay Range

• $280,841.60 USD Annually - $393,182.40 USD Annually

With a mission to heal and inspire the human spirit, Inland Empire Health Plan (IEHP) is one of the top 10 largest Medicaid health plans and the largest not-for-profit Medicare‑Medicaid plan in the country. In its 29th year, IEHP supports nearly 1.6 million members who are enrolled in Medicaid and has a growing network of over 8,000 providers and nearly 4,000 Team Members (Employees). Through dynamic partnerships, award-winning service, and a tradition of quality care, IEHP is fully committed to its Mission, Vision, and Values.

IEHP has consistently achieved outstanding employee engagement scores from their 4,000+ Team Members and was most recently recognized and awarded the designation of ‘Great Place to Work’ for a fifth year in a row!

For details regarding IEHP, please visit: .

About the Position:

The Chief Financial Officer (CFO) is responsible for the financial management of the organization to include premium rate development, actuarial services, directed payments, budget analysis/management, financial modeling and reporting, cost benefit analysis, capitation development, claim operations, forecasting needs, facilities, payroll, accounting/treasury operations, internal auditing, risk insurance management, and purchasing including the procurement process.

In addition to providing financial leadership for IEHP, this position will be responsible for actuarial planning, forecasting, and analysis of financial/organizational risk associated with Medi‑Cal, Covered California, and Medicare CCI Dual lines of business. The CFO will offer quality, meaningful analyses, and financial perspectives necessary for organizational decisions and strategic/operational planning. The CFO is also responsible for the following non-financial departments – Claims, Property Management, Facilities, Business Continuity, Medical Economics, and Risk Score Management for Medi‑Cal, Covered California, and DSNP products.

Responsibilities:

• 
  
• Oversees and directs budgeting, financial audits, MCO tax, accounting, capitation, purchasing, premium rate development with the DHCS, Covered California, and CMS, procurement of capital equipment, services and supplies, long‑range forecasting, risk insurance management activities, recovery of claim overpayments, financial auditing of IPAs and vendors, internal audit, and treasury for IEHP.
  
• Manages staff to develop and implement procedures and computer application systems necessary to maintain proper records and to afford adequate accounting controls and services.
  
• Ensures staff is engaged, well informed, and aligned with organizational priorities through clear communication, ongoing coaching, and professional development opportunities.
  
• Provides strategic leadership and insights into IEHP’s business lines while actively partnering with executive leaders to drive alignment, inform decision making, and ensure financial sustainability across the organization.
  
• Oversees production of monthly comprehensive financial and actuarial reports.
  
• Coordinates treasury activities such as custodian of funds and IEHP’s assets.
  
• Appraises IEHP’s financial position and issues periodic reports on the organization’s financial stability, liquidity, and growth.
  
• Develops the annual operating and capital budgets.
  
• Analyzes, consolidates, and directs all cost accounting procedures together with other statistical and routine reports.
  
• Oversees and directs the preparation and issuance of the annual audit.
  

The ideal candidate will bring deep expertise in Medi‑Cal/Medicaid health plan finance, with a strong understanding of the rate setting process and a demonstrated ability to collaborate effectively with state partners. This individual must be a strategic thinker who asks insightful questions, anticipates challenges and quickly identifies issues. A broad understanding of the health plan landscape along with a disciplined, data-informed approach to budgeting and performance monitoring is critical to this role.

The CFO will be an experienced and engaging leader who is passionate about mentoring and developing teams. Strong interpersonal skills and a collaborative style are ideal attributes as the CFO will work closely with leaders across the organization and build trusted relationships with internal and external stakeholders. The CFO will act as an advocate for the health plan with regulatory bodies and external partners. This individual must thrive in a collaborative, service-oriented culture that values transparency, genuine partnership and community impact.

Staff: Direct reports include Vice President, Finance; Vice President, Actuarial Services; Vice President, Property Management & Development; Senior Director, Claims; Director, Procurement & Supply Chain; Executive Assistant; total staff of 524.

Experience/Knowledge Requirements:

• 
  
• Ten (10) years of experience in finance/accounting with a minimum of five (5) years of experience in a managed care environment, and a minimum of five (5) years of staff management experience.
  
• Experience with Medi‑Cal or Medicaid is required and existing Medi‑Cal experience and relationships with DHCS are preferred.
  
• The financial aspects of a managed care health plan, including finance, accounting, capitation, fee‑for‑service, procurement process, actuarial support, claim overpayments, internal auditing, risk pools, Rate Development Template (RDT)/Directed Payment Program (DPP), risk corridors, and MLR requirements.
  

Educational Requirements:

• 
  
• Bachelor’s degree in Finance or related field is required.
  
• Master’s degree in a relevant financial field from an accredited institution is preferred.
  

Salary range: A reasonable starting salary expectation is between $517,213 – $603,408, based upon related/relevant experience and internal equity.

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