NCQA Accreditation and Special Projects Analyst at San Francisco Health Plan in San Francisco, California

Job Description:

Under the general direction of the Manager, National Committee for Quality Assurance (NCQA) and Special Projects, you will support the San Francisco Health Plan (SFHP) Accreditation Program through communication and implementation of evolving requirements, mock survey and monitoring activities.

Responsibilities include:

• Coordinate mock and official accreditation surveys
• Assist in reviewing, compiling, and annotating evidence
• Communicate with internal and external clients regarding NCQA requirements and proposed changes
• Projects for the Regulatory Affairs and Compliance Department.

Salary: $86,000 to $100,000

WHAT YOU WILL DO:

• Ensure compliance with NCQA Accreditation standards by comparing policies and procedures, reports, materials, files, and other documentation to the standards; recommend opportunities to strengthen compliance and member experience.
• Assist the Manager, NCQA and Special Projects, in development and implementation of mock surveys and NCQA Accreditation Surveys.
• Communicate with departmental contributors regarding survey and mock survey deliverables, progress, and findings.
• Assist with maintaining up-to-date accreditation work plans.
• Assist in the monitoring of SFHP's policies and procedures with working knowledge of policy development and approval process. Assist with suggesting changes based on feedback from mock surveys.
• Assist with communicating and discussing requirements with delegates.
• Train internal subject matter experts before surveys and upon request on how to annotate evidence.
• Monitor regulatory, industry, and compliance climate and escalate issues.

WHAT YOU WILL BRING:

• Bachelor's degree in business, public health, or other related areas, or equivalent experience.
• Three years of experience in the healthcare industry and operations
• Experience with an NCQA accreditation survey.
• Quality improvement background that includes managed care and NCQA, specifically within the Medicaid and government-sponsored programs environments.

WHAT WE OFFER:

• Health Benefits
  • Medical: You'll have a choice of medical plans, including options from Kaiser and Blue Shield of California, heavily subsidized by SFHP.
  • Dental: You'll have a choice of a basic dental plan or an enhanced dental plan which includes orthodontic coverage.
  • Vision: Employee vision care coverage is available through Vision Service Plan (VSP).
• Retirement – Employer-matched CalPERS Pension and 401(a) plans, 457 Plan.
• Time off – 23 days of Paid Time Off (PTO) and 13 paid holidays.
• Professional development: Opportunities for tuition reimbursement, professional license/membership.

ABOUT SFHP:

Established in 1997, San Francisco Health Plan (SFHP) is 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 175,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services.

San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

San Francisco Health Plan is an E-Verify participating employer.

Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.

#LI-Hybrid

PI253957454