Salary : $151,985.75 - $184,739.64 Annually
Location : Martinez, CA
Job Type: Non-Merit Advertise Only
Job Number: VCD2-2026A
Department: Health Services
Opening Date: 10/01/2026
Closing Date: 10/25/2026 11:59 PM Pacific
FLSA: Exempt
Bargaining Unit: B8
The PositionWhat you will typically be responsible for:- Providing leadership and oversight of all CCHP claims operations, including claims adjudication, adjustments, payment integrity, and recovery activities
- Directing, coaching, and evaluating managers and supervisors responsible for daily claims operations
- Overseeing clearinghouses and other claims-related vendors, including contract performance and issue resolution
- Directing the use and optimization of Epic Tapestry for claims adjudication, payment rules, edits, and reporting, and ensuring system changes are appropriately tested, documented, and implemented
- Ensuring full compliance with federal, state, and local regulations, including DHCS, DMHC, and CMS requirements
- Establishing and monitoring key performance indicators related to claims timeliness, accuracy, financial controls, and regulatory compliance
- Serving as the primary liaison for claims-related matters with providers, county partners, auditors, and regulatory agencies
- Identifying operational risks, audit findings, and systemic issues, and ensuring timely corrective action and reporting to executive leadership
A few reasons you might love this job:- You will shape the strategic direction of claims operations for a large, mission-driven public health plan
- You will have a direct impact on provider payment accuracy, regulatory compliance, and financial stewardship
- You will work with experienced, dedicated professionals committed to equity, accountability, and operational excellence
- You will play a key role in supporting healthcare access for Contra Costa County's most vulnerable populations
A few challenges you might face in this job:- Navigating frequent changes in Medi-Cal, Medicare, and managed care claims regulations
- Balancing regulatory compliance, financial controls, and provider experience in a complex environment
- Managing system limitations, data dependencies, and cross-functional coordination
- Leading large-scale operational improvements while maintaining day-to-day performance
Competencies Required:- Delegating- Ability to inspire and create new leaders by developmental opportunities
- Coaching and Developing Others- Ability to mentor and have staff grow professionally
- Managing Performance- Leader in finding creative ways to recognize staff in a governmental environment
- Visionary Leadership- Influence a team to believe in working in a high performing environment and not accept the bureaucratic myth - or a mentality for doing minimum work
- Teamwork- Collaborating with others is critical in this role
- Leading Cross-Divisional Collaboration- Patient and empathetic leaders will be successful in understanding the sensitivities of clinical teams
- Managing and Facilitating Change- Commitment to be being a Change Agent due to the heavy demands on policies with governmental programs
- Professional Impact- May be called upon to be a Public Relations guru in helping the CEO with external issues in the community and the Safety Net providers
- Fact Finding- Research and obtain reliable data and facts for projects
To read the complete job description, please visit the website:
Minimum QualificationsEducation: Possession of a master's degree from an accredited college or university with a major in Business Administration, Health Care Administration, Public Administration, Public Health, or a closely related field.
Experience: Five (5) years of progressively responsible professional experience in health care administration, health plan operations, or a closely related field, including at least two (2) years in a management or supervisory capacity.
Substitution for Education: Possession of a Bachelor's degree from an accredited college or university and two (2) additional years of qualifying experience may be substituted for the Master's degree. Two (2) additional years of qualifying experience may be substituted for academic major concentration.
Desirable Qualifications:- Delivering Results: Achieves organizational and regulatory goals through strong operational leadership and accountability
- Legal & Regulatory Navigation: Interprets and applies complex laws, regulations, and guidance
- Ownership & Accountability: Takes responsibility for outcomes and ensuring follow-through across teams
- Technology Leadership: Guides the effective use of claims and payment systems to support operational performance, data integrity, and regulatory requirements, while partnering with IT on system enhancements and upgrades
- Oral Communication: Effectively communicates complex information to executive and external audiences
Selection Process This position is exempt from the merit system and will not follow regular County recruitment and selection procedures. Only the most qualified candidates will be invited to interview.Application Filing and Evaluation: Interested individuals should submit an online application and provide all required documentation to be considered.
