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Regulatory Affairs Analyst

San Francisco Health Plan

San Francisco Health Plan

IT, Legal
San Francisco, CA, USA
Posted on Wednesday, July 3, 2024

Come join an organization that makes a difference in the underserved San Francisco Communities! At San Francisco Health Plan (SFHP), we are currently looking for a Regulatory Affairs Analyst.

Under the general supervision of the Regulatory Affairs Counsel, the Regulatory Affairs Analyst supports essential regulatory affairs functions within the Regulatory Affairs and Compliance department. You will be responsible for continuous reconciliation of the organization’s policies and procedures (P&Ps) and desktop processes within federal and State laws, regulations, and sub-regulatory guidance.

You will:

  • Audit results, processes impacting health care providers, and NCQA accreditation standards.
  • Support activities relating to regulatory inquiries, regulatory filings, reporting, implementation of new regulatory guidance. Activities range from routine to complex, requiring excellent judgment and decision-making abilities.

In this role you will grow to have extensive knowledge of the organization’s operations, State managed care laws and regulations, Medi-Cal program requirements, as well as substantial knowledge in the areas of health care compliance and new health care reform initiatives at the state and local levels (e.g. Medi-Cal program transitions and expansions).

The ideal candidate will be professional and able to demonstrate high standards of integrity and confidentiality in a fast-paced environment. The candidate must be strong in organizational skills, attention to detail and accuracy as they are essential to carrying out regulatory affairs activities and assisting team members.

Please note - San Francisco Health Plan supports a hybrid work environment and as such this position will be onsite, in office a minimum of 4 days per month.

Salary range: $84,000 - $94,000 per year

WHAT YOU WILL DO

  • Maintain inventory of policies and procedures (P&Ps) in the organization’s P&P database (Square One)
  • Translate policy issues and regulatory requirements to clear and concise P&Ps
  • Ensure all P&Ps are reviewed frequently and updated as necessary. Serve as the primary point person for document content and storage.
  • Work with other departments to develop new policies as needed. Coordinate P&Ps development and revisions across impacted departments.
  • Clearly communicate requirements and P&P changes to applicable SFHP management and staff; ensure staff are aware of changes to ensure that desktop processes and trainings are updated to reflect changes.
  • Ensures activities of the Policy and Compliance Committee are current on Square One.
  • Train SFHP staff on development, revisions, and maintenance of Policies, Procedures, and Desktop Procedures.
  • Oversee and conducts internal audits as assigned; coordinate audits by governmental agencies as assigned.
  • Train staff on aspects of new legislation, contracts, compliance, HIPAA and other regulations and sub regulatory guidance.
  • Serve as one of the department liaisons with State agencies.
  • Draft, coordinate, and oversee State regulatory filings.
  • Analyze and coordinate implementation of new regulations and legislation.
  • May provide backup for timely responses to State inquiries, including ad hoc inquiries, State Fair Hearings, Independent Medical Review requests, Consumer Complaints, discrimination grievances, and expedited grievances.
  • When needed, acts as a Discrimination Grievance Coordinator by investigating grievances against SFHP staff that allege any action that would be prohibited by, or out of compliance with, federal or state nondiscrimination laws.

WHAT YOU WILL BRING

  • Bachelor’s degree or equivalent work experience; JD or other experience in reviewing contracts preferred
  • Two years of experience in analyzing and interpreting health care laws, regulations, and policies desired
  • Healthcare Compliance Certification preferred
  • Experience in a health plan environment preferred
  • Strong working knowledge of State program regulations and HIPAA
  • Data experience in health care desired

WHAT WE OFFER

A competitive and robust compensation package, including:

  • Health benefits
    • Medical: You’ll have a choice of medical plans, including options from Kaiser and Blue Shield of California. Employee-only coverage in the Blue Shield HMO plans is currently available at no cost and dependent coverage is 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.
  • 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

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. San Francisco Health Plan is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 140,000+ 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, 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.