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Behavioral Health Program Coordinator, South San Francisco, CA


Health Plan of San Mateo

Behavioral Health Professional

South San Francisco, CA

August 16, 2019


BEHAVIORAL HEALTH PROGRAM COORDINATOR

The Health Plan of San Mateo (HPSM), a managed care health plan, seeks a full time Program Coordinator for our Behavioral Health and Integrated Services unit of Health Services. The position is responsible for generating reports that speak to process and outcomes and maintaining a catalog of the unit’s policies and procedures. Specifically this helps support NCQA submissions, internal Behavioral Health and LTSS quality assurance, and operational monitoring. Report duties include submission of requests to informatics, collating such requests, and running ad hoc reports in self-serve systems. With guidance from the Director in the department, this role will conduct some analyses, review work, and provide an explanation and interpretations within their area of expertise.

The essential duties and responsibilities will include the following:

  • Assists in the preparation of reports that analyze and track quality of service and utilization statistics; develop and implement quality monitoring and reporting for the Behavioral Health and Integrated Services unit.
  • Coordinates and assists with ensuring continuity of end-to-end quality assurance processes, managing reports, and disseminating analyses to appropriate stakeholders.
  • Under the direction of the Director, will participate in focused quality assurance reviews to identify operational compliance with processes and opportunities to maximize operational efficiencies.
  • Maintain understanding of business rules and regulatory requirements pertaining to Behavioral Health and Integrated Services.
  • Provide administrative and clerical support for daily activities through data entry, member tracking, analytical work, and non-clinical research.
  • Create, maintain, and monitor regular and ad-hoc reports to ensure operational effectiveness and program compliance with regulatory standards.
  • Assist with project plans, Gantt charts, achievements, outcome tracking and summary slides for tracking purposes.
  • Assist in performing root cause analysis (RCA) for identified concerns, including but not limited to timeliness standards, customer service, audit findings, and other critical operational processes.
  • Serve as back up for manual data entry, process documentation, and creation of visual workflows for the department.
  • Maintain desk top procedures and policies and procedures for the departments.
  • Participate in on-site/webinar audits, as needed.
  • Assist with data, program eligibility and clinical information gathering for quality assurance and care coordination.
  • Assist with meeting minutes, scheduling and delegation of assignments, as needed.
  • Perform other duties as assigned

Requirements

Education and Experience: Associate of Arts Degree in science or health science. Bachelor’s degree preferred. Minimum of three (3) years of relevant experience such as working in a medical office/practice, acute care hospital, managed care health plan, etc.

Knowledge of: Managed Care Processes. Relevant federal, state, and regulatory requirements. Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access, and PowerPoint. Excel data formulas, pivot tables, and creating visual charts from data.

Ability to: Learn and apply relevant federal and state regulatory requirements. Work cooperatively with others. Work as part of a team and support team decisions. Multi-task with demanding timeframes. Communicate effectively, both verbally and in writing. Adapt to changes in requirements/priorities for daily and specialized tasks

Compensation and Benefits

Starting Compensation Range: - Depending on Experience

Benefits Information: Excellent benefits package offered, including HPSM paid premiums for employee’s Medical, Dental and Vision coverage. Employee pays a small portion of the dependent premiums (5%) for medical and dental benefits. Additional HPSM benefits include fully paid life, AD&D, and LTD insurance; retirement plan (HPSM contributes equivalent of 10% of annual compensation); holiday and vacation pay; tuition reimbursement plan; onsite fitness center and more.

How to Apply

Application Process: To apply, submit a resume and cover letter with salary expectations to: Health Plan of San Mateo, Human Resources Department, 801 Gateway Blvd., Suite 100, South San Francisco, CA 94080 or via email: careers@hpsm.org or via fax: (650) 616-8039. File by: Continuous until filled. The Health Plan of San Mateo is proud to be an Equal Opportunity Employer and encourages minority candidates of all backgrounds to apply.

Submissions without a Cover Letter and Salary Expectations may not be considered.


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