Health Plan Manager in Los Angeles, California at Sunlight Group

About Sunlight Health

Sunlight Health delivers tech-enabled, family-centered Enhanced Care Management (ECM) and other aligned services for families impacted by the child welfare and justice systems. We partner with CASA programs, dependency legal services organizations, and child welfare agencies to address healthcare and social determinants of health — meeting families in courthouses, communities, and their lives.

The Opportunity

Health plan relationships are at the center of how Sunlight Health sustains its mission. We're hiring a Health Plan Manager to own these relationships end-to-end — from contracting and compliance to reporting, relationship development, and identifying new enterprise growth opportunities.

This role picks up critical work previously spread across leadership and builds it into a dedicated function. You'll manage active health plan relationships (CenCal, Partnership Health Plan, LA Care, HealthNet, Molina, and others) while developing the infrastructure to support expanded contracts and new plan partnerships as we scale.

This is a startup — and that's not a footnote. We're a small, fast-moving team with no bureaucracy to hide behind. You'll wear multiple hats, navigate ambiguity, make judgment calls with incomplete information, and build systems that don't exist yet. The ideal candidate has thrived in an early-stage or high-growth environment and knows the difference between building for scale and over-engineering before you need it. If that energizes you, great. If it doesn't, this role isn't the right fit.

What You'll Do

Health Plan Relationship Management

• Serve as primary point of contact for Sunlight Health's health plan partners — managing day-to-day communication, reporting, and escalations
• Build trust-based relationships with health plan leadership, contract managers, and clinical liaisons
• Ensure contractual commitments are met on both sides; proactively surface and resolve issues
• Represent Sunlight Health in health plan meetings, performance reviews, and joint operating committee sessions

Contracting & Compliance

• Own the health plan contracting lifecycle — renewals, amendments, rate negotiations, and new contract execution
• Track contract terms, performance requirements, and reporting obligations across all health plan agreements
• Coordinate internally to ensure clinical operations and documentation practices align with plan requirements
• Monitor regulatory and policy changes (CalAIM, Medi-Cal managed care) and translate implications for internal teams and health plan partners

Reporting & Performance

• Manage all health plan reporting obligations — encounter data, quality metrics, utilization reports, and ad hoc requests
• Build internal dashboards and tracking systems to monitor performance against health plan benchmarks
• Identify gaps in performance and work with clinical operations to close them
• Develop materials for health plan performance reviews and strategic planning conversations

Enterprise Growth

• Identify opportunities to expand existing health plan relationships — new populations, expanded service lines, additional counties
• Support outreach to new health plan partners as Sunlight Health scales geographically
• Develop proposals, term sheets, and presentations for prospective health plan partnerships
• Stay current on the CalAIM and ECM market landscape to identify emerging contract opportunities

What You Bring

Required

• 4–7+ years of health plan operations, managed care contracting, or provider relations experience
• Deep understanding of Medi-Cal managed care, CalAIM, or ECM reimbursement and contracting mechanics
• Track record managing health plan relationships at a provider organization, health plan, or managed care entity
• Experience owning reporting obligations and performance management with health plan partners
• Strong commercial instincts — you understand how contracts translate to revenue and can identify growth opportunities
• Excellent communication and relationship skills; comfortable operating with health plan executives and clinical leaders

Highly Valued

• ECM, Community Supports, CHW, Behavioral Health, or LTSS contracting experience in California
• Experience at an early-stage or growing healthcare company where you built functions from scratch
• Background in child welfare, behavioral health, or safety net healthcare
• Bilingual (Spanish/English)

What Success Looks Like

• Health plan contracts are actively managed, compliant, and renewed on favorable terms
• Reporting obligations are met on time with clean, accurate data
• Health plan relationships are strong — partners trust Sunlight Health and proactively share opportunities
• At least one new health plan contract or contract expansion completed within 12 months
• Internal teams have clarity on health plan requirements and how to meet them

Why Sunlight Health

You'll own a function that directly determines organizational sustainability and growth. This isn't a support role — it's a commercial and operational leadership position at a company building something new in California's safety net. You'll have direct access to the CEO, real ownership over outcomes, and the opportunity to build a health plan management function that scales.