Work Preference
Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Manny Rivera
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Manny Rivera

Salem

Work Preference

Job Search Status

Open to work
Desired start date: Immediately

Desired Job Title

Executive DirectorChief Operating OfficerSenior Quality Improvement AnalystLead Prepaid Health Plan AnalystHuman Resources Officer

Work Type

Full Time

Location Preference

RemoteOn-Site
Location: Salem, ORPortland, OR
Open to relocation: Yes

Important To Me

Work-life balanceCompany CultureHealthcare benefitsWork from home optionTeam Building / Company Retreats401k match

Summary

Experienced dual track leader. Healthcare leader skilled in governance, regulatory compliance, and stakeholder engagement. Track record of building high-performing teams and fostering collaborative environments to drive health equity and operational excellence across community health initiatives.

Human Resources leader skilled in end to end Human Resources and People operations.

Overview

25
25
years of professional experience

Work History

Executive Director

WVP Health Authority
Salem
01.2020 - 01.2026
  • Partnered with the Board of Directors to establish strategic priorities while serving as primary liaison for executive reporting, strategic recommendations, governance matters, and enterprise risk oversight.
  • Provided executive leadership, strategic direction, and operational oversight for a community-focused healthcare organization supporting health plan and community health initiatives.
  • Directed enterprise operations across programs, contracts, compliance, finance, and administrative services, ensuring alignment with organizational goals and long-term sustainability.
  • Ensured compliance with Medicaid, CMS, state contract, and nonprofit governance requirements while leading audit readiness, corrective action plans, and risk mitigation strategies.
  • Led strategic planning initiatives to enhance health service delivery across communities.
  • Built and led high-performing leadership teams through talent development, succession planning, workforce design, and organizational effectiveness initiatives.
  • Implemented KPI-driven performance management frameworks that strengthened accountability, operational performance, and continuous improvement.
  • Fostered a culture of collaboration, transparency, innovation, and service excellence across the organization.
  • Represented the organization with regulators, providers, partners, and community stakeholders while leading high-level negotiations and strategic relationships tied to funding, partnerships, and performance.
  • Collaborated with stakeholders to develop policies improving patient care standards.
  • Directed team efforts in implementing community outreach and engagement activities.
  • Analyzed data on health trends to inform strategic decision-making processes.
  • Recruited, trained, mentored, evaluated, coached, and managed staff members to ensure success in achieving their goals.
  • Cultivated relationships with key stakeholders, including board members, donors, sponsors, partners, and community leaders.
  • Evaluated programs for improvement opportunities and identified new initiatives based on market analysis, driving innovation and responsiveness to community needs.

Chief Operating Officer

WVP Health Authority
Salem
01.2009 - 12.2019
  • Oversaw OHP Medicaid, Medicare SNP, Commercial, IPA, medical group, and home health operational functions.
  • Led multi-department operations across an integrated healthcare system including health plan administration, provider operations, and support services.
  • Directed Medicaid enrollment, eligibility, customer service, claims and encounters, provider relations, contracting, credentialing, appeals and grievances, and medical management.
  • Led workflow redesign and process improvement initiatives to enhance service delivery, efficiency, and stakeholder satisfaction.
  • Developed and implemented strategies to increase operational efficiency.
  • Established enterprise policies, controls, and performance metrics aligned with strategic and regulatory expectations.
  • Maintained compliance with state and federal contracts, delegated oversight requirements, and governance standards.
  • Oversaw technology integration projects to improve operational efficiency.
  • Led cross-functional teams to implement process improvements, resulting in more effective patient care workflows.
  • Managed budget planning and resource allocation for efficient organizational performance.
  • Developed and refined short- and long-term strategies to drive growth and profitability.
  • Led organizational development changes, enabling organization to better respond and adapt to industry and market changes.
  • Led employees to develop high-performing diverse teams and deliver on ambitious goals and objectives.
  • Established key performance indicators for measuring success.
  • Developed operational policies and processes, guaranteeing staff maintained compliance with federal, state and local laws and regulations.
  • Served as strategic advisor and functional expert on critical strategic and operational matters.
  • Identified new business opportunities through market research analysis.
  • Implemented solutions that resolved operational problems and mitigated risks, ensuring smoother organizational operations.
  • Partnered on organizational growth initiatives, new programs, and service expansion opportunities.

Senior Quality Improvement Analyst

WVP Health Authority
Salem
08.2007 - 12.2009
  • Led Quality Improvement initiatives across Medicaid, Medicare Advantage, and Dual Eligible programs.
  • Managed performance improvement projects (PIPs) and ensured audit readiness through proactive planning.
  • Supported HEDIS, CAHPS, Stars, and state quality performance strategies through gap analysis and interventions.
  • Collaborated with provider networks and internal teams to improve quality outcomes.
  • Analyzed healthcare data to identify trends and improve patient outcomes.
  • Translated data and trends into actionable recommendations, enhancing decision-making for executive leadership.
  • Developed annual QI work plans, evaluations, and regulatory reporting deliverables.
  • Collaborated with cross-functional teams to develop strategic health programs.
  • Prepared detailed reports for stakeholders to evaluate program effectiveness and inform strategic recommendations.
  • Identified opportunities for process improvements across the organization.

Lead Prepaid Health Plan Analyst

Oregon Department of Human Services
Salem
03.2001 - 08.2007
  • Led contract oversight and compliance monitoring for multiple Medicaid health plans.
  • Managed development, oversight, and continuous improvement of statewide Medicaid managed care delivery systems.
  • Supported design, procurement, and contract development for Medicaid managed care models to enhance service delivery.
  • Developed and managed Operational Assessment Reviews (OARs), readiness reviews, and corrective action tracking.
  • Coordinated audits, desk reviews, site visits, and regulatory reporting with state and federal entities to ensure compliance and improve oversight.
  • Partnered with health plans, providers, and internal teams to improve program performance and compliance.
  • Advanced quality improvement and value-based care initiatives supporting population health outcomes.

Education

MASTER OF BUSINESS ADMINISTRATION -

Willamette University
Salem, Oregon

BACHELOR OF SCIENCE -

Portland State University
Portland, Oregon

Skills

  • Oregon Medicaid / OHP
  • Healthcare operations
  • Government Programs
  • Regulatory Compliance
  • Compliance oversight
  • Quality improvement
  • Risk management
  • Data analysis
  • Budget oversight
  • Program management
  • Policy development
  • Medical management
  • Program management
  • Budget oversight
  • Stakeholder engagement
  • Governance & Board Relations
  • Board relations
  • Policy development
  • Health equity
  • Data analysis
  • Operations management
  • Talent management
  • Business management
  • Team leadership
  • Relationship building
  • Board relations
  • Policy development
  • Talent management
  • Business management

Languages

Spanish
Professional

Timeline

Executive Director

WVP Health Authority
01.2020 - 01.2026

Chief Operating Officer

WVP Health Authority
01.2009 - 12.2019

Senior Quality Improvement Analyst

WVP Health Authority
08.2007 - 12.2009

Lead Prepaid Health Plan Analyst

Oregon Department of Human Services
03.2001 - 08.2007

MASTER OF BUSINESS ADMINISTRATION -

Willamette University

BACHELOR OF SCIENCE -

Portland State University

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Manny Rivera