You are part of the Provider Relations team and will work with contracting and the Provider Network Operations Manager to evaluate the breadth and depth of the provider network, research providers to address weak points in coverage, and build rewarding relationships to ensure a strong network of medical caregivers.
SFHP proudly supports a hybrid work environment. This role will be required to be in-office, on-site a minimum of 4 days per month.
Responsibilities:
- Maintain source data for a Provider Directory that complies with all provisions of California law.
- Perform demographic data entry for new, modified and termed providers, ensuring accurate information.
- Conduct quality assurance review and analysis.
- Maintain metrics to measure the efficiency of the data entry process.
- Provide training on the QNXT provider module and the relevant load functions and vendor set up in QNXT.
- Provide support in developing processes to review and validate all provider data housed in QNXT provider module.
- Ensure that all data capture, transfer, and entry of practitioner data comply with NCQA, Medi-Cal and other regulations.
- Provide support in maintaining other provider databases (e.g. provider portal, credentialing records).
- Foster an environment that solicits and enlists diverse and inclusive perspectives and approaches to better serve our staff, our members and our providers.
Minimum Qualifications:
- Two years of college in a relevant area such as business, public health or other relevant areas; or equivalent work experience in health care or provider network.
- Proficiency with Excel, Word, SharePoint, and Outlook.
- Familiarity with relational data warehouses, queries, SQL are a plus, but not required.
- Demonstrated collaboration and problem solving skills.
WHAT WE OFFER:
- Medical: You’ll have a choice of medical plans, including options from Kaiser and Blue Shield of California, 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.
ABOUT SFHP:
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.
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.
Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.
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