Established in 1997, San Francisco Health Plan (SFHP) is a an award winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco county. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 145,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves, and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.
Under the direction of the Manager, Delegation Oversight, the Delegation Oversight Coordinator organizes and coordinates SFHP’s various delegation oversight audit processes including scheduling, follow up with both internal and external customers and document management and distribution.
WHAT YOU’LL DO
- Support coordination of audit process (scheduling, communication with delegate, and communication with internal stakeholders).
- Assist Manager, Delegation Oversight with preparation of Provider Network Oversight Committee (PNOC) meeting schedule, materials, meeting minutes, and follow up on action items.
- Follow up with delegated groups for timely receipt of required reports. Track receipt of reports, save reports in SharePoint, and inform SMEs of their availability.
- Track delegated groups’ CAP responses, and informs Delegation Oversight Specialist of their availability.
- Assist with the review and development of audit tools.
- Assist with the development of training materials for SMEs.
- Assist with the review of department policies, desktop procedures, and other documents.
- Represent Provider Network Operations Department at internal cross-functional meetings as needed.
- Represent SFHP at external meetings as needed.
- Perform other duties as assigned.
WHAT YOU’LL BRING
- BA/BS in Business Administration, Compliance, Social Sciences, or related field required.
- Prior experience with health care audits; knowledge of health care compliance in managed care systems and/or provider organizations
- Experience with taking meeting minutes
- Ability to work with multiple departments within the organization and external clients
- Knowledge of managed care and Medi-Cal and other state-sponsored health programs strongly preferred
- Ability to communicate effectively (spoken and written) with a variety of professionals, including physicians and other health providers, administrators and others
- Detail-oriented and organized with the ability to interpret policy and make decisions
- Demonstrated ability in versatility, flexibility, professionalism and to learn quickly
- Strong computer and Web aptitude, solid understanding of how to use common platforms and applications to set up templates and streamline reporting and communications
- Demonstrated working ability using a total managed care system
- Very strong MS Office skills: Outlook, Word, Excel, and PowerPoint
- Experienced with electronic file management, SharePoint preferred
San Francisco Health Plan is an Equal Opportunity Employer (EOE) M/F/D/V
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.