hero

Transform your impact at one of these organizations

NCQA Accreditation Analyst

San Francisco Health Plan

San Francisco Health Plan

IT
San Francisco, CA, USA
Posted on Thursday, August 3, 2023

Under the general direction of the Program Manager, National Committee for Quality Assurance (NCQA) and Special Projects, you will be responsible for supporting the San Francisco Health Plan (SFHP) Accreditation Program through communication and implementation of evolving requirements, mock surveys and monitoring activities. Three key areas of focus include:

  • Coordination and participation in mock and official accreditation surveys;
  • Assistance with reviewing, compiling, and annotating evidence; and
  • Communicating effectively and efficiently with internal and external clients regarding NCQA requirements and proposed changes.

Hiring priority will be given to applicants residing in the San Francisco Bay Area or California.

WHAT YOU'LL DO

  • Ensure compliance with NCQA Health Plan Accreditation and NCQA Health Equity Accreditation standards by comparing policies and procedures, reports, materials, files, and other documentation to the standards; recommends opportunities to strengthen compliance and member experience.
  • Assist in development and implementation of mock surveys and NCQA accreditation surveys.
  • Communicate with departmental contributors regarding survey and mock survey deliverables, progress, and findings.
  • Participate in the monitoring of SFHP’s policies and procedures with strong working knowledge of policy development and approval process.
  • Collects mock survey feedback and suggests changes based on that feedback.
  • Trains internal subject matter experts before surveys and upon request on how to annotate evidence.
  • Monitors regulatory, industry, and compliance climate and escalate issues when necessary.
  • Maintains a strong working knowledge of state and federal legislation, statutes and regulations, and local, state, and national health issues affecting publicly-funded managed care organizations, particularly those impacting quality, member experience, and health equity.

WHAT YOU'LL BRING

  • Bachelors Degree, or equivalent experience.
  • A minimum of three (3) years of experience in health care industry and operations
  • Experience with an NCQA accreditation survey highly preferred.
  • Possesses a strong quality improvement background that includes managed care and NCQA within a Medicaid and government sponsored program environment.
  • Exemplary interpersonal skills, including ability to work effectively as part of a team across organizational structure.
  • Experience in coordinating and providing support to large complex projects.
  • Excellent attention to detail and organizing abilities.
  • Excellent logic, planning and problem-solving skills.
  • Ability to analyze varying and large amounts of data to extrapolate meaning and use; detect and report on findings and trends, and support conclusions and recommendations using valid sources of data.
  • Ability to analyze, summarize, and interpret legislative, statutory, regulatory, and legal language.
  • Advanced level proficiency with MS Office 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
  • Possess inquisitive and analytical problem solving skills with demonstrated initiative and ability to work independently.

WHAT WE OFFER

A competitive and robust compensation package, including:

  • Health benefits – several plan choices to cover you and your dependents medical, dental, vision needs
  • Retirement – Employer-matched CalPERS Pension and 401(a) plans, 457 Plan
  • Time off – 23 days of Paid Time Off (PTO) and 13 paid holidays
  • An opportunity to work in a vibrant atmosphere with the most amazingly talented people who are shaping the future of healthcare!
  • The chance to make a difference in the lives of many San Francisco residents!

ABOUT US

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. 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 proud to be an equal opportunity employer. We are committed to a work environment that supports and respects all individuals and in which our 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.