Senior Manager - Managed Care Operations

Full Job Description

Under the direction of the Chief of Managed Care Operations, the Senior Manager – Managed Care Operations (MCO), will provide a strategic leadership role overseeing key functions critical to the daily operations and regulatory responsibilities of the Behavioral Health Providers (BHP), including Provider Network Management (PNM), Utilization Management (UM), Plan-to-Plan Coordination, and Care Management for high-risk and special populations.

The Senior Behavioral Health Manager – Managed Care Operations will ensure that these functions operate in accordance with Medi-Cal and Medicare standards, regulatory requirements from the California Department of Health and Care Services (DHCS) and the Centers for Medicare & Medicaid Services, (CMS), as well as Ventura County’s Behavioral Health mission of accessible, high-quality behavioral health care.

IDEAL CANDIDATE

Ventura County Behavioral Health Department is seeking a knowledgeable, results-oriented individual to support the core operational responsibilities of the County’s Behavioral Health Plan (BHP), under the direction of the Chief of Managed Care Operations.

The ideal candidate will possess a strong foundation in healthcare operations, Medi-Cal managed care, and behavioral health system delivery.

They must demonstrate a deep understanding of provider contracting functions and workflows, including contract development, compliance, monitoring, and collaboration with legal and fiscal teams.

Success in this role requires the ability to manage complex, fast-paced, and multi-layered coordination with both internal divisions and external County and system partners.

WHAT WE OFFER
The County of Ventura offers an attractive compensation and benefits package. In addition to the annual salary, an employee within these positions may also be eligible for the following:

• Bilingual Incentive - Incumbents may be eligible for bilingual incentive depending upon operational needs and certification of skill.
• Educational Incentive - Incumbents may also be eligible for an educational incentive of 2.5% for completion of an associate degree, 3.5% for completion of a bachelor’s degree, or 5% for completion of a graduate degree for educational attainments not specifically required by the position.
• Deferred Compensation - Eligible to participate in the County's 401(k) Shared Savings Plan and/or the Section 457 Plan.
• Health Plans - Full-time employees are afforded a flexible credit allowance for purchasing medical, dental, and/or vision insurance from a group of authorized plans.
• Flexible Spending Accounts - Choice of participation in the Flexible Spending Accounts which increase spending power through reimbursement of pre-tax dollars for IRS approved dependent care and health care expenses.
• Pension Plan - Both the County and employees contribute to the County's Retirement Plan and to Social Security. If eligible, reciprocity may be established with other public retirement systems, such as PERS.
• Holidays - 12 paid days per year which includes a scheduled floating holiday.

PAYROLL TITLE

Senior Behavioral Health Manager

AGENCY/DEPARTMENT: Health Care Agency – Behavioral Health

Senior Behavioral Health Manager classification is Management/Confidential and is not eligible for overtime compensation. Incumbents in this classification are eligible for benefits at the MB3 level.

The eligible list established from this recruitment may be used to fill current and future Regular (including Temporary and Fixed-Term), Intermittent, and Extra-Help vacancies. There is currently one (1) Regular vacancy.

TENTATIVE SCHEDULE

OPENING DATE: March 19, 2026

CLOSING DATE: April 2, 2026

Requirements

• Leads and oversees Provider Network Management (PNM) operations, including provider contracting, credentialing, enrollment, oversight, and network adequacy monitoring.
• Supports staff with PNM workflows, resolves issues, and ensures contract compliance when needed.
• Directs and supports Utilization Management (UM) operations, ensuring compliance with DHCS and CMS requirements, timely service authorizations, and appropriate medical necessity reviews.
• Acts as a hands-on resource and operational back-up for UM processes and data tracking.
• Manages and guides Plan-to-Plan coordination with Medi-Cal Managed Care Plans (MCPs), with a focus on level-of-care transitions, shared-member follow-up, and closed-loop communication, which includes escalating and resolving complex coordination issues in partnership with internal and external teams.
• Oversees and reinforces Care Management functions for high-risk and special populations, including Medi-Medi beneficiaries and individuals requiring cross-system coordination, which includes direct support to Care Management teams and cross-divisional collaboration to ensure client engagement and service continuity.
• Drives collaboration with internal partners in Quality, Compliance, Fiscal, Legal, and Data Departments to align workflows, support audit readiness, and ensure coordinated service delivery across MCO functions.
• Applies operational knowledge of DHCS, CMS, and Medi-Cal/Medicare regulations to lead implementation of compliant processes, supports real-time troubleshooting, and ensures the division’s readiness for audits, performance reviews, and reporting mandates.
• Represents and advocates for Managed Care Operations in high-level projects, strategic planning efforts, and interagency initiatives, while supporting front-line managers in operational execution and external stakeholder coordination.
• Performs other duties as required.

Qualifications

These are entrance requirements to the examination process and assure neither continuance in the process nor placement on an eligible list.

EDUCATION, TRAINING, AND EXPERIENCE

Extensive supervision, program operation or management experience, or technical related experience which has led to the acquisition of the required knowledge, skills and abilities. The required knowledge, skills, and abilities may also be obtained by:

Any combination of education, training, and experience equivalent to:

• Bachelor’s degree in health administration, behavioral health, public administration, or a related field and
• Minimum of five (4) years of progressively responsible management experience in managed care, behavioral health operations, or public healthcare systems.

NECESSARY SPECIAL REQUIREMENTS

• Demonstrated operational knowledge of Medi-Cal and Medicare, including applicable DHCS and CMS requirements related to Behavioral Health Plan (BHP) functions.
• Established experience in provider contracting, utilization management, care coordination, and cross-system collaboration across clinical, administrative, and payer environments.
• Strong leadership, organizational, and communication skills, with a demonstrated ability to lead multi-disciplinary teams and navigate complex, multi-agency systems.

DESIRED

Master’s degree

Five (5) plus years of supervision of manage care operations.

Knowledge, Skills, and Abilities

Thorough knowledge of:

• mental health and substance abuse assessment, treatment, and case management practices;
• behavioral health clinical policies and procedures;
• principles and practices of strategic planning;
• management and supervision;
• budgetary preparation, analysis, monitoring, and administration;
• organizational development and staffing;
• application of office automation to business practices;
• contract negotiation and administration;
• fund development;
• internal and external marketing of services; and
• public relations.

Ability to:

• analyze, develop, implement, and evaluate organizational and service delivery systems;
• plan, organize, and supervise the work of others to reach agency goals;
• maintain collaborative working relationships with staff, community members, and other governmental agencies;
• develop and/or present training programs for staff and others;
• utilize personal computing hardware and software;
• research and prepare a variety of reports and recommendations;
• maintain medical record standards;
• provide active and positive leadership;
• develop community resources;
• work within budget constraints;
• respond effectively to crises;
• effectively handle persons who are angry, demanding, emotionally upset and/or resistant to treatment;
• evaluate safety and risk factors for staff and clients; and
• communicate effectively in an oral and written manner to a wide variety of audiences.

Additional Information

Your application must be received by County of Ventura Human Resources in Ventura, California, no later than 5:00 p.m. on Friday, December 5, 2025.

To apply on-line, please refer to our web site at www.venturacounty.gov/jobs. If you prefer to fill out a paper application form, please call (805) 677-5184 for application materials and submit them to County of Ventura Human Resources – Health Care Agency, 646 County Square Dr., Ventura, CA 93003.

LATERAL TRANSFER OPTION: If presently permanently employed in another "merit" or "civil service" public agency/entity in the same or substantively similar position as is advertised, and if appointed to that position by successful performance in a "merit" or "civil service" style examination, then appointment by "Lateral Transfer" may be possible.

If interested, please click here for additional information.

Note to Applicants

It is essential that you complete all sections of your application and supplemental questionnaire thoroughly and accurately to demonstrate your qualifications.

A resume and/or other related documents may be attached to supplement the information in your application and supplemental questionnaire; however, it/they may not be submitted in lieu of the application.

SUPPLEMENTAL QUESTIONNAIRE – qualifying: All applicants are required to complete and submit the questionnaire for this examination at the time of filing.

The supplemental questionnaire may be used throughout the examination process to assist in determining each applicant's qualifications and acceptability for the position.

Failure to complete and submit the questionnaire will result in the application being removed from consideration.

APPLICATION EVALUATION – qualifying: All applications will be reviewed to determine whether or not the stated requirements are met. Those individuals meeting the stated requirements will be invited to continue to the next step in the screening and selection process.

TRAINING & EXPERIENCE EVALUATION: A Training and Experience Evaluation (T&E) is a structured evaluation of the job application materials submitted by a candidate, including the written responses to the supplemental questionnaire.

The T&E is NOT a determination of whether the candidate meets the stated requirements; rather, the T&E is one method for determining who are the better qualified among those who have shown that they meet the stated requirements.

In a T&E, applications are either scored or rank ordered according to criteria that most closely meet the business needs of the department.

Candidates are typically scored/ranked in relation to one another; consequently, when the pool of candidates is exceptionally strong, many qualified candidates may receive a score or rank which is moderate or even low resulting in them not being advanced in the process.

NOTE: The selection process may consist of an Oral Exam, which may be preceded by or replaced with the score from a Training and Experience Evaluation (T&E), contingent upon the size and quality of the candidate pool.

In a typical T&E, your training and experience are evaluated in relation to the background, experience and factors identified for successful job performance during a job analysis.

For this reason, it is recommended that your application materials clearly show your relevant background and specialized knowledge, skills, and abilities.

It is also highly recommended that the supplemental questions within the application are completed with care and diligence.

Responses such as "See Resume” or "Refer to Resume" are not acceptable and may disqualify an applicant from further evaluation.

ORAL EXAMINATION – 100%: A job-related Oral Examination will be conducted to evaluate and compare participating candidates' knowledge, skills, and abilities in relation to those factors which job analysis has determined to be essential for successful performance of the job.

Applicants must earn a score of seventy percent (70%) or higher to qualify for placement on the eligible list.

If there are three (3) or fewer qualified applicants, an oral examination will not be conducted.

Instead, a score of seventy percent (70%) will be assigned to each application, and each applicant will be placed on the eligible list.

Applicants successfully completing the examination process may be placed on an eligible list for a period of one (1) year.

BACKGROUND INVESTIGATION: A thorough post offer, pre-employment background investigation which may include inquiry into past employment, education, criminal background information, and driving record may be required for this position.

EQUAL EMPLOYMENT OPPORTUNITY

The County of Ventura is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding, and related medical conditions), and sexual orientation.

To apply visit: www.venturacounty.gov/jobs or for further information about this recruitment, please contact Rhiannon Flores by telephone at (805) 677-5318 or via e-mail at Rhiannon.Flores@venturacounty.gov.