• Only open to candidates residing in California
• Opportunity to make a difference in your community
• Position not eligible for sponsorship

General Description

Responsible for engaging with the Provider Services (PS) team and other impacted departments [e.g. Compliance Department, Policy Implementation Unit (PIU), etc.] to develop, manage, and improve PS regulatory and accreditation efforts (e.g. DHCS, DMHC, CMS, NCQA, etc.). The PS Regulatory Program Manager serves as a subject matter expert, the liaison to impacted teams within the organization, and provides operational and relationship support on PS compliance/regulatory related activities.

Duties & Responsibilities

Essential Functions:

· Manage program(s) from initiation through delivery and monitor for continuous improvement.

· Serve as primary point person and relationship liaison with internal departments (e.g. Compliance Department, Policy Implementation Unit, etc.) and key stakeholders.

· Develop methods, techniques, and evaluation criterion for obtaining results with a special focus on project management.

· Plan, execute, and evaluate program initiatives to improve performance and deliver results to a wide range of audiences.

· Participate cross functionally in business planning to support HPSM initiatives with a focus on regulatory and accreditation standards.

· Educate and work with PS department and internal stakeholders to identify innovation opportunities and improve processes and outcomes.

· Function as an organizational subject matter expert on Provider Services regulatory and accreditation requirements.

· Monitor and stay up to date with DHCS, DMHC, CMS, NCQA requirements, and any other regulatory and/or accreditation requirements.

· Monitor and ensure timely submission of regulatory and accreditation Corrective Action Plans (CAPs) for department.

· Manage without authority by proactively connecting owners to deliverables while meeting deadlines.

· Appropriately escalate concerns to supervisor while holding stakeholders accountable.

· Engage in critical thinking and creative problem solving, appropriately pivoting program priorities to meet business needs.

· Continuously align program goals with department and enterprise-wide goals.

Secondary Functions:

· Perform other duties as assigned.

Requirements

These are the qualifications typically needed to succeed in this position. However, you don’t need to meet every requirement to apply.

Education and experience

· Bachelor's degree in healthcare management, business administration, or a related field. Master's degree preferred.

· Three (3) years of experience in public health or healthcare setting, working with provider network, project management or program development and evaluation.

· Experience with Medi-Cal and Medicare programs/members preferred.

Knowledge of:

· Microsoft Office suites, knowledge of Excel, Visio, PowerPoint (required).

· Process improvement applications and principles (required).

· Strong knowledge of federal and state healthcare regulations, such as DHCS, DMHC, CMS, MCQMD, NCQA preferred.

Ability to:

· Work cooperatively with others.

· Work as part of a team and support team decisions.

· Adapt to changes in requirements/priorities for daily and specialized tasks.

· Think critically and make informed decisions.

· Perform multiple projects efficiently and with limited oversight, reprioritizing as appropriate.

· Communicate effectively, verbally and in writing.

Skills:

· Excellent project management skills with a track record of successful program implementations.

· Exceptional communication, interpersonal, and negotiation skills.

· Strong organizational skills with ability to prioritize assignments and maintain effective filing systems and meet deadlines.

· Detail-oriented with a focus on accuracy and compliance.

Salary and benefits

The starting salary range is $89,554 - $118,659 per year, depending on the candidate’s work experience.

Excellent benefits package includes:

· HPSM-paid premiums for employee’s medical, dental and vision coverage (employee pays 10% of each dependent’s premiums).

· Fully paid life, AD&D and LTD insurance.

· Retirement plan (HPSM contributes equivalent of 10% of annual compensation).

· 12 paid holidays a year, 12 paid sick days a year and paid vacation starting at 16 days a year.

· Tuition reimbursement plan.

· Employee wellness program.

It is HPSM's policy to provide equal employment opportunity for all applicants and employees. HPSM does not unlawfully discriminate based on race, religion, color, national origin, ancestry, physical disability, mental disability, medical condition, marital status, sex, age, sexual orientation, veteran status, registered domestic partner status, genetic information, gender, gender identity, gender expression, or any other characteristic protected by applicable federal, state, or local law. HPSM also prohibits discrimination based on the perception that an applicant or employee has any of those characteristics or is associated with a person who has or is perceived to have any of those characteristics.

Job Type: Full-time

Pay: $89,554.00 - $118,659.00 per year

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Referral program
• Retirement plan
• Tuition reimbursement
• Vision insurance

Experience level:

• 2 years
• 3 years

Schedule:

• 8 hour shift
• Monday to Friday

Location:

• South San Francisco, CA (Required)

Work Location: Remote