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Manager, Facility Site Review

Company: L.A. Care Health Plan
Location: Los Angeles
Posted on: November 23, 2021

Job Description:

Job Category: Administrative, HR, Business Professionals Department: Facility Site Review Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 7039 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 in five health plans, 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 Manager, Facility Site Review (FSR) will work under the guidance of the Director of Provider Support Services. The Manager of Facility Site Review is responsible for the organization, compliance, direction and staffing of L.A. Care's Facility Site Review (FSR) function(s). Responsibilities includes supervisory visits of staff conducting site reviews and/or physical accessibility review survey (PARS) assessments, maintain regulatory compliance, oversight of plan partner related operations, operations for direct lines of business and/or management of services agreement functions, and interfacing with external agencies including other Managed Care Plans (MCPs). The Manager of Facility Site Review will conduct site reviews when appropriate and necessary. The Manager of Facility Site Review is further responsible to assure all functions are operating in accordance with the organization's mission, values and strategic goals and are provided in a manner that is responsive and sensitive to the needs of L.A. Care's culturally diverse membership. Duties Develop and maintain a culturally sensitive work environment that promotes staff growth and education. Responsible for the completion of performance appraisals, recruitment and retention, training and mentoring staff. Conduct various types of site review visits to include, but not limited to, initials, periodic reviews, interim reviews, focused reviews, investigative visits, PQIL visits, etc. Conduct supervisory visits as appropriate and necessary. Oversee the training of new FSR team members. Take a lead role in chairing internal FSR meetings, participate and contribute in FSR Collaborative activities and meetings, oversee and document results of annual Plan Partner oversight audits, and maintain compliance with regulatory requirements. Develops, implements, and reviews departmental policies and procedures. Requests assistance from Director as needed to accomplish goals. Oversees and develops responsible departmental budgets in line with organizational goals. Leads various meetings as necessary and appropriate. Maintains confidentiality in compliance with all HIPAA requirements. Communicates to Director any barriers to completing assignments or daily work in an efficient and effective manner. Supports L.A. Care's Mission, Vision, and Values in daily performance. Perform other duties as assigned.-- Education Required Bachelor's Degree In lieu of degree, equivalent education and/or experience may be considered. Education Preferred Experience
Required:
A minimum of 6-8 years of Facility Site Review experience. At least 3-5 years of experience in a supervisory/management role in a managed care setting. Clinical background in in-patient and/or ambulatory care. Experience in obtaining and sustaining regulatory compliance. Preferred:
FSR/Audit review experience strongly preferred. Experience with Medi-Cal regulations. Skills
Required:
Excellent verbal and written communication and collaboration skills. Excellent problem solving, planning, and organizational skills. Strong problem-solving, planning and analytical skills. Excellent organizational skills. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Certified Master Trainer (CMT) Certified Site Reviewer Required Training Additional Information L.A. Care offers--a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program At L.A. Care, we value our team members' safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.
    Nearest Major Market: Los Angeles
    Job Segment: Medical, Nursing, Registered Nurse, Healthcare

Keywords: L.A. Care Health Plan, Los Angeles , Manager, Facility Site Review, Professions , Los Angeles, California

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