San Francisco Health Plan

  • Provider Relations Specialist

    Job Locations US-CA-San Francisco
    Job ID
    2018-1450
    Category
    Operations
    Type
    Regular Full-Time
  • Overview

     

    The Specialist will serve as a crucial liaison to SFHP’s networks of providers, hospitals, and health systems, including independent clinics, mental health professionals, and ancillary providers.  This person will work as an independent part of the Provider Relations team to provide excellent customer service and regulatory guidance to provider organizations.  The ideal candidate will work well in a fast-paced environment and will be responsive to the fluctuating needs of the organization, the providers, and of the regulatory bodies which govern its work.

     

    The Specialist is one of the faces of the health plan to the provider community, which will include handling provider complaints, questions and issues, representing our department at cross-functional meetings, and meeting with providers at their offices. The Specialist assists providers with logistics and set up of trainings on the rights, resources and responsibilities of a provider in Medi-Cal managed care.

     

    WHAT YOU WILL DO

     

    • Serve as liaison between the Health Plan and delegated medical groups, independent community clinics, mental health professionals, and ancillary providers.
    • Be the primary contact person at the Health Plan for certain high-touch providers and organizations.
    • Via phone and in person, answer questions and solve problems in an efficient and timely manner with an emphasis on long-term relations, customer service and professionalism.
    • Communicate clearly and concisely with providers and their support staff.
    • Represent Provider Relations Department at internal cross-functional meetings.
    • Perform other duties as assigned.

     

    WHAT YOU WILL BRING

     

    • BA/BS in Social Sciences, Business or related field; or equivalent work experience in a health care environment
    • Prior experience in a managed care setting, provider organization, or with health policy is required.
    • Experience in relationship management and directing a coordinated response to sometimes complex problems is a must
    • Ability to communicate effectively both written and verbally to professionals at all levels of the Plan and with external organizations. Knowledge and application of English grammar including composition, editing and proofreading skills. Demonstrated ability to learn quickly
    • Ability to produce accurate and precise work, detect discrepancies and resolve discrepancies all while meeting deadlines.
    • Ability to work effectively, independently, and as part of a team
    • Strong organization, time management skills and multi-tasking abilities
    • Strong computer and Web aptitude; proficient with MS Office tools and applications including Access, Excel, Word, Outlook is required.
    • Demonstrated working ability using a total managed care system
    • Experienced with electronic file management, SharePoint preferred
    • Experience with presentations and leading diverse groups to a project goal
    • Detail oriented and organized with the ability to interpret policy and make decisions

     

     

    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.

     

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