What are the responsibilities and job description for the Community Supports Program Administrator position at Inland Empire Health Plan?
Overview:
Reporting to the Director of Community Supports, the Community Supports Program Administrator provides strategic guidance, operational oversight, and programmatic expertise for Community Supports initiatives. This role is responsible for managing complex programs, leading cross-functional initiatives, ensuring regulatory compliance, and optimizing provider performance to improve member outcomes. The incumbent serves as a subject matter expert and key liaison between internal departments, provider partners, and external stakeholders.
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.
Additional Benefits:
Operational Oversight
Provider Network Management
Regulatory, Compliance & Quality
Data, Reporting & Performance Management
Stakeholder Engagement & Communications
Ownership & Mentorship
Qualifications:
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 Director of Community Supports, the Community Supports Program Administrator provides strategic guidance, operational oversight, and programmatic expertise for Community Supports initiatives. This role is responsible for managing complex programs, leading cross-functional initiatives, ensuring regulatory compliance, and optimizing provider performance to improve member outcomes. The incumbent serves as a subject matter expert and key liaison between internal departments, provider partners, and external stakeholders.
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.
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
- 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
Program Guidance & Strategy
1. Lead planning, implementation, and ongoing management of Community Supports programs, ensuring alignment with CalAIM, DHCS APLs, contract requirements, and organizational strategy.
2. Translate policy and regulatory guidance into operational workflows, job aids, and scalable program processes.
3. Identify program risks, gaps, and opportunities; develop mitigation strategies and continuous improvement plans.
4. Identify program risks, gaps, and opportunities; develop mitigation strategies and continuous improvement plans.
Operational Oversight
5. Oversee day-to-day operations of assigned Community Supports programs, ensuring performance targets, service delivery standards, and timelines are met.
6. Develop, maintain, and monitor program workflows, Standard Operating Procedures (SOPs), and operational tools.
7. Partner with Finance, Claims, IT, Compliance, and Quality teams to ensure end-to-end operational integrity (referrals, authorizations, billing, reporting).
8. Ensure appropriate escalation and resolution of complex operational issues.
Provider Network Management
9. Serve as primary programmatic lead for Community Supports providers.
10. Oversee provider onboarding, readiness, and ongoing monitoring activities.
11. Collaborate with provider partners to improve performance, resolve operational challenges, and support compliance with contractual and regulatory requirements.
12. Lead corrective action planning when performance, compliance, or quality issues are identified.
Regulatory, Compliance & Quality
13. Ensure Community Supports programs comply with applicable APLs, policy guidance, contracts, and audit requirements.
14. Support internal and external audits, including documentation review, corrective actions, and response development.
15. Partner with Compliance and Quality teams to develop monitoring tools and oversight frameworks.
16. Maintain up-to-date knowledge of evolving state and federal requirements impacting Community Supports.
Data, Reporting & Performance Management
17. Define and monitor KPIs, utilization trends, provider performance metrics, and member outcomes.
18. Use data to drive program improvements, inform leadership decisions, and support reporting requirements.
19. Prepare executive-level reports, dashboards, and presentations summarizing program performance and risks.
Stakeholder Engagement & Communications
20. Act as a key liaison with internal leaders, external partners, counties, and state agencies as needed.
21. Lead cross-functional workgroups and meetings related to Community Supports initiatives.
22. Communicate complex program information clearly to diverse audiences.
Ownership & Mentorship
23. Provide guidance, coaching, and mentorship to Program Managers and other team members.
24. Lead special projects and enterprise-wide initiatives related to Community Supports.
25. Contribute to team development, knowledge sharing, and best practice standardization.
26. Perform any other duties as required to ensure Health Plan operations and department business needs are successful.
Qualifications:
Education & Requirement
- A minimum of five (5) years of progressively responsible experience in healthcare program management, population health, or Community Supports-related services
- Demonstrated experience with CalAIM Community Supports, Medicaid managed care, or social services programs
- Application experience of standard Project Management Practices
-
Master’s degree from an accredited institution required
- In lieu of a Master’s degree, a relevant certification (i.e., PMP, PgMP, CBAP or PMI‐PBA) and a bachelor’s degree from an accredited institution is required
Key Qualifications
- Valid California Driver’s License preferred
-
Advanced knowledge and understanding in the following areas:
- Developing plans with project management and cross-organization coordination
- Key operational information and key organizational tactical / strategic information through the effective implementation of data initiatives
- Data Initiatives including data trending analyses, data profiling, data mining, data analysis, and promoting a data-aware culture throughout an organization
- Understanding and sensitivity to a multi-cultural environment and community
-
Healthcare regulations, contracts, and compliance requirements
- Strong interpersonal skills, strong project management skills, and strong issue management skills. Microcomputer applications: spreadsheet, database, and word processing
- Must have excellent writing, interpersonal communication, and organizational skills
-
Proven ability to:
- Possess a high degree of patience
- Show attention to detail
- Work in changing, fast-paced environment
- Support a culture of collaboration
- Translate data into meaningful and actionable information
- Manage complex programs and lead cross-functional initiatives
Start your journey towards a thriving future with IEHP and apply TODAY!
This position is on a hybrid work schedule. (Monday & Friday - remote, Tuesday – Thursday onsite in Rancho Cucamonga, CA.)
Pay Range: USD $91,249.60 - USD $120,910.40 /Yr.Salary : $91,250 - $120,910