Director, Special Projects Medical Management
at Health Plan of San Joaquin

Date Posted: 3/28/2019

Job Description

Under general supervision, the Director of Strategic Initiatives and Special Projects is responsible for managing special projects that require collaboration within the various areas of Medical Management other departments within HPSJ, as well as external entities. Work is varied and complex, and requires a moderate degree of discretion and independent judgment.
Essential Functions
  • Leads research and development of special programs and projects as directed by the CMO.
  • Works with internal and external resources to develop financial models and feasibility analysis for new projects.
  • Defines project’s objective, scope and success measures in collaboration with CMO and directors.
  • Leads the identification and prioritization of special projects within Medical Management; oversees or manages project implementations.
  • Identifies, secures and manages, oversees or assists with the identification, securing and management of internal and external project resources.
  • Leads development, implementation and maintenance of best practice methodology, including but not limited to technology, policies, procedures, processes, tools and standards; ensures their dissemination and understanding among stakeholders.
  • Develops and manages, or oversees the development and management of department and project budgets.
  • Develops, implements and maintains, or oversees the development, implementation and maintenance of the appropriate and required data, records, reports, and other documentation.
  • Serves as the key content expert for the projects and ensures leadership for the project from inception to implementation and evaluation.
  • Ensures Medical Management’s preparedness for and compliance with Regulatory changes and state audits and leads these activities through Matrix management.
  • Represents Medical Management and HPSJ in a manner that promotes a positive image of HPSJ in the community.
  • Serves on internal and external committees as needed.
  • Promotes and maintains an environment that supports HPSJ’s strategy, vision, mission and values.


Job Requirements

Required Skills
  • In-depth knowledge of the health care industry, its critical issues and major challenges.
  • In-depth knowledge of health care delivery systems.
  • Knowledge of managed care, including its products, services, major business functions and their interactions.
  • Knowledge of California Managed Medicaid regulatory requirements and NCQA accreditation requirements.
  • Financial acumen: Interprets and applies understanding of key financial indicators to make better business decisions.
  • Strong skills in budget development and management, with demonstrated ability to bring large, complex projects in on time and on budget.
  • Advanced assessment and analytical skills, including the ability to synthesize, distill concepts, draw conclusions and identify implications.
  • Manages complexity: Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
  • Decision quality: Makes good and timely decisions that keep the organization moving forward.
  • Strategic mindset: Sees ahead to future possibilities and translates them into breakthrough strategies; creates, executes and monitors relevant strategic and business plans.
  • Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities.
  • Plans and aligns: Plans and prioritizes work for self and others to meet commitments aligned with organization goals.
  • Ensures accountability: Holds self and others accountable to meet commitments.
  • Drives results: Consistently achieves results, even under tough circumstances.
  • Strong interpersonal skills, including but not limited to the ability to establish and maintain effective working relationships with individuals at all levels both inside and outside of HPSJ.
  • Strong oral and written communication skills, including but not limited to the ability to communicate professionally to diverse individuals and groups inside and outside of HPSJ; Includes presentations, with the ability to tailor presentations to a specific audience.
  • Advanced presentation skills, including but not limited to the ability to tailor presentations to a specific audience, be persuasive and identify key messages.
  • Strong collaboration skills, including but not limited to the ability to create and foster a collaborative work environment, and organize people and resources to solve problems and identify opportunities.
  • Builds networks: Effectively builds formal and informal relationship networks inside and outside of the organization.
  • Organizational savvy: Maneuvers comfortably through complex policy, process and people-related organizational dynamics.
  • Persuades: Uses compelling arguments to gain the support and commitment of others.
  • Manages ambiguity: Operates effectively, even when things are not certain or the way forward is not clear.
  • Strong knowledge of change management theory, with ability to anticipate and implement effectively.
  • Demonstrated ability to articulate and support HPSJ’s vision, mission, values and strategy, integrate into management practices, and foster their manifestation among staff.
  • Expert knowledge of the principles and best practices of project management, including, but not limited to: project life cycle, scope definition and management, planning and scheduling, monitoring, communication cycles, project team and risk management.
  • Ability to speak and be understood in English.
  • Ability to treat confidential information with appropriate discretion.

Required Experience
  • Bachelor’s Degree in Nursing, Bachelor’s degree in Business or similar; and
  • At least five years experiences in implementing various projects and audits; or
  • Equivalent combination of education and experience.

  • Experience in project management in healthcare and/ or Medi-Cal/ Medicaid.
  • Master’s Degree in Healthcare.
  • Strong understanding of the California healthcare landscape.

Licenses, Certifications
  • Valid California driver license and reliable transportation or, the ability to obtain transportation on demand if prohibited from getting a driver license due to a medically documented disability.
  • Project management certificate or equivalent experience.
  • Current unrestricted California RN license (If RN).


Job Snapshot

  • Employee Type: Full-Time
  • Location: French Camp, CA
  • Experience: Not Specified
  • Date Posted: 3/28/2019

About Us

For over 20 years, Health Plan of San Joaquin (HPSJ) has delivered access to hands-on, high-touch, quality health care for our diverse Central Valley communities. We do this by remaining as we began: nimble, resourceful and local. After two decades of communitywide partnerships and service:

  • More residents want to be our members
  • More providers prefer to be in our network
  • Hundreds of community-based organizations continue to come to us, whether for leadership, to make common cause on behalf of the health and well-being of our residents, or to host health condition-focused outreach and initiatives

For HPSJ employees, our commitment is professional and our dedication is personal: To provide health care value and advance wellness through community partnerships. We are a mirror to the rich cultural diversity of our service area, San Joaquin and Stanislaus counties. Our employees appreciate several benefits while working for HPSJ, such as four medical plan options, dental, vision, three retirement plans, and the opportunity to collaborate with others who are dedicated to providing high quality healthcare to our members.

HPSJ Community Report – The Story of Us

Each of our over 300 HPSJ employees can take justifiable pride in the role they play to make possible access to quality health care for over 340,000 members. We invite you to walk through the HPSJ Community Report, and hope you find it informative. For each of us at HPSJ, it has generated justifiable feelings of personal and professional pride.

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