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Facility Site Review Coordinator II

$50.22k

L.A. Care Health Plan

Facility Site Review Coordinator II Job Category: Administrative, HR, Business Professionals Department: Facility Site Review Location Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 13148 Salary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County’s vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Facility Site Review (FSR) Coordinator II ensures the accuracy of provider and site information by pre-screening information with provider's office staff and internal departments as appropriate. Contacts provider offices and conduct telephonic interviews to assess FSR needs prior to the Nurse Reviewers’ arrival, prepares and sends pre-audit packets to providers, monitors incoming emails from Plan Partners to enter FSRs scheduled via the FSR scheduling website, enters new provider data to website as requested by Provider Network Operations (PNO), and addresses telephonic and/or email requests from internal PNO Department, providers and plan partners regarding various site reviews and medical record reviews. Duties Coordinate with primary care physician (PCP) sites to prepare for their initial and periodic site reviews. Review pertinent provider data and status as it relates to the Facility Site Review requirements and functions. (20%) Interview provider site’s office staff for educational needs to prepare for their site reviews. Coordinate site and educational packets to the provider as needed and notify Nurse Reviewers of site reviews needed to schedule. (15%) Coordinate information of provider data and/or status to update the FSR scheduling website daily to reflect requests from the L.A. County Collaborative Health Plans, Plan Partners, and L.A. Care's assigned site reviews in regards to PCP and/or site information change in status. (15%) Coordinate changes, additions, and removal of PCP status changes to the L.A. Care network and L.A. County Collaborative between the FSR and Provider Network Operations (PNO) departments and other departments as appropriate. (15%) Coordinate Nurse Reviewers scheduled audits and appropriate site review packets for PCP scheduled sites and other appropriate types of audits. (10%) Review, prepare, and coordinate with Nurse Reviewers periodic full scope reviews due for a site review three months prior to the expiration date. (10%) Document and track PCP status changes to the L.A. Care network and L.A. County Collaborative. Document and track Nurse Reviewers audits to ensure site reviews are scheduled timely and within DHC requirements. (5%) Perform other duties as assigned. (10%) Experience Required: At least 1 year of experience and knowledge of facility site review processes and requirements; or 1 year of healthcare experience in a similar field; or 1 year of coordination experience; or 1 year in an assistant/receptionist position. Skills Excellent computer skills, MS Word, Access, and Excel. Excellent organizational skills. Proficient in problem solving. Ability to handle multiple priorities. Education Preferred Associate's Degree Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. #J-18808-Ljbffr L.A. Care Health Plan

Vacancy posted 2 days ago
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