Are you ready to make a difference in San Francisco? We have an exciting opportunity for the policy minded professionals!
The Policy Analyst will ensure the staff at San Francisco Health Plan (SFHP) will have current and clear policy direction for departmental and procedural decision-making. This position will be responsible for continuously reconciling all Policies and Procedures (P&Ps) and desktop processes with state and regulatory requirements and audits SFHP benefits, Contracts, Network Operations Manual and NCQA guidelines.
WHAT YOU WILL DO
- Maintain inventory of Policies and Procedures in Square One
- Ability to translate policy issues to clear and concise Policies and Procedures.
- Ensure all Policies and Procedures (P&Ps) are reviewed frequently and updated as necessary.
- Serve as the primary point person for document content and appropriate storage.
- Work with SFHP staff to identify policy areas that need updating and clarification and ensure that documents are modified appropriately for approval by appropriate SFHP committees.
- Work cross departmentally to develop new policies as needed.
- Work with Audit Analyst to audit and monitor compliance with policies and procedures
- Clearly communicate policy changes to relevant SFHP staff and management; ensure staff and management are aware of changes to ensure that desktop procedures and trainings can be updated to reflect new policies.
- Serve as the Compliance and Regulatory Affairs liaison for policy and compliance information across the organization
- Ensure alignment of P&Ps with California State regulations and laws, NCQA requirements, audit findings, benefits, contracts, member materials, and our Network Operations Manual.
- Support Compliance and Regulatory Affairs in administration of Policy and Compliance Committee
- Communicate Policy and Compliance Committee activities and decisions to SFHP staff via the SFHP Intranet and Square One.
- Ensure appropriate and meaningful storage and categorization of all P&Ps, including effective dates and clear revision histories and ensure appropriate access to P&Ps for all SFHP staff.
- Coordinate Policies and Procedure development and revisions across impacted departments
- Train SFHP staff on development, revisions, and maintenance of Policies, Procedures, and Desktop Procedures.
- Monitor trends and makes suggestions to improve current practices.
- Provide feedback to Policy and Compliance Committee on staff adherence to P&Ps.
WHAT YOU WILL BRING
- Bachelors degree in business administration or closely related field, or equivalent experience
- Experience in policy and procedure development preferred
- Experience with Medi-Cal, Medicaid, and/or Department of Health Care Services regulations and standards, work experience in an HMO or in a managed care setting preferred
- Experience with information organization – document inventory management systems knowledge a plus for proper version control and “effective date” management preferred
- History with NCQA or large-scale accreditation projects desired
- Ability to apply regulatory, contractual, and accreditation requirements to SFHP operational policies and procedures within the appropriate scope and context
- Exceptional organization, time management and program management skills
- Exceptional written and verbal communication skills
- Ability to produce accurate and precise work, detect discrepancies and resolve discrepancies while meeting deadlines
- Ability to work effectively, both as part of a team and independently
- Strong knowledge and application of English grammar including composition, editing and proofreading
- Intermediate level proficiency with MS applications (Word, Excel, PowerPoint, Sharepoint) with expertise with word processing, spreadsheets, graphics and presentation software including the ability to create tables; merge documents; and develop graphics and PowerPoint presentations from notes
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. San Francisco Health Plan is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 142,000+ 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.
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.