FACILITY SITE REVIEW COORDINATOR III

2 weeks ago


CA United States L.A. Care Health Plan Full time
Salary Range: $55,245.00 (Min.) - $69,045.00 (Mid.) - $82,867.00 (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 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

Under the general direction of the FSR Manager, the Facility Site Review (FSR) Coordinator III functions as subject matter expert in Coordinator roles and responsibilities. FSR Coordinator III provides training and updates to FSR coordinators and FSR new hires. FSR Coordinator III works with various internal departments/service areas, L.A. Care's plan partners, participating provider groups, and other external agencies. Works with FSR Manager and Project Manager to streamline and improve FSR processes, implement new FSR system, and other projects as needed. The FSR Coordinator will attend internal meetings as designated.

Duties

As subject matter expert, services as a resource to FSR Coordinators, and FSR management with Facility Site Review Coordinator responsibilities. Serves as subject matter expert when representing FSR to other internal departments.

Review pertinent provider data and status as it relates to the Facility Site Review requirements and functions. Works with department management and key stakeholders to resolve any concerns prior to site reviews.

Coordinate site and educational packets to the provider as needed and notify Nurse Reviewers of site reviews needed to schedule. Reviews packet materials, recommends necessary updates or changes to management and key stakeholders.

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.

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.

Coordinate Nurse Reviewers scheduled audits and appropriate site review packets for PCP scheduled sites and other appropriate types of audits.

Review, prepare, and coordinate with Nurse Reviewers periodic full scope reviews due for a site review three months prior to the expiration date.

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 DHCS requirements.

Trains new FSR coordinators and other new staff as needed.

Develops Desk Top Procedures on all core functions of the coordinator.

Attends leadership meetings as needed.

Collaborates with and keeps the Health Services Leadership apprised of operational issues, staffing issues, system and program needs. Actively identifies and implements efforts to improve the quality, effectiveness and efficiency of job functions.

Communicates to supervisors any barriers to completing assignments or daily work in any efficient and effective manner.

Assists co-workers with special projects or work volume as required. Actively identifies and implements efforts to improve the quality, effectiveness and efficiency of job functions. Actively identifies and makes recommendations to supervisor ideas to improve the quality effectiveness and efficiency of departmental and health services functions. Communicates to supervisors any barriers to completing assignments or daily work in an efficient and effective manner.

Perform other duties as assigned.

Duties Continued

Education Required

High School Diploma/or High School Equivalency Certificate

Education Preferred

Associate's Degree

Experience

Required:

At least 0-2 years of experience with facility site review processes and requirements; or 5 years of healthcare experience in a similar field; or 5 years of coordination experience; or 5 years in an assistant/receptionist position.

Skills

Required:

Excellent interpersonal and communication skills, both verbal and written.

Ability to work effectively with various levels of the organization and external vendors/agencies.

Excellent computer skills, MS Word, Access, and Excel.

Excellent organizational skills.

Proficient in problem solving.

Ability to handle multiple priorities.

Time management and priority setting skills.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Light

Additional Information

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.

L.A. Care offers a wide range of benefits including

* Paid Time Off (PTO)
* Tuition Reimbursement
* Retirement Plans
* Medical, Dental and Vision
* Wellness Program
* Volunteer Time Off (VTO)

Nearest Major Market: Los Angeles

  • , GA, United States Blue Cross Blue Shield of South Carolina Full time

    We are currently hiring for a (RN) Medical Reviewer III to join Palmetto GBA. In this role as (RN) Medical Reviewer III, you will perform medical reviews using clinical/medical information provided by physicians/providers and established criteria/pro Medical, Processing, Microsoft, Clinical, Health, Insurance, Healthcare


  • Moorestown, NJ, United States Cooper University Health Care Full time

    About Us At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to its employees by providing...


  • Soldotna, AK, United States Alaska Christian College Full time

    JOB TITLE: Title III Wellness CoordinatorDEPARTMENT: Title III ProjectREPORTS TO: Title III Project DirectorSTATUS: Part Time, Grant Funded, Non-ExemptPURPOSE: To develop ACC's new Wellness Center and the gradual implementation of the college's nutritional, physical, financial, and mental wellness programs for students.RESPONSIBILITIES:1. Develop financial...


  • , VA, United States Inova Health System Full time

    The Patient Care Coordinator III provides industry leading clinical coordination and facilitation services to meet the healthcare needs of patients entering the system. Works in a dynamic and team focused environment, must be highly organized, be able to communicate effectively in person and over multiple written and verbal electronic modalities. In...

  • Clin Nurse III

    1 day ago


    Harriman, TN, United States Covenant Health Inc. Full time

    Overview Registered Nurse I-III, Medical Surgical Unit PRN/OCC, Hours vary, Day Shift Roane Medical Center Overview: Proudly serving our community, Roane Medical Center is committed to your healthy future! Our state-of-the-art facility is equipped with modern technologies and expert staff to provide you the best possible patient care. From...

  • Clin Nurse III

    1 day ago


    Maryville, TN, United States Covenant Health Inc. Full time

    Overview Registered Nurse, Maryville Infusion Center $5,000 Sign-on Bonus for experienced RNs Full time, 80 hours per pay period, Day Shift Oncology Infusion RN for Thompson, Blount and Lenoir City Infusion Centers. Monday/Tuesday Blount location Wednesday/Thursday Lenoir City location Friday may be floated to other sites Position...


  • , VA, United States Inova Health System Full time

    The Patient Care Coordinator III provides industry leading clinical coordination and facilitation services to meet the healthcare needs of patients entering the system. Works in a dynamic and team focused environment, must be highly organized, be able to communicate effectively in person and over multiple written and verbal electronic modalities. In...


  • , CA, United States Common Spirit Full time

    OverviewFounded by the Sisters of Mercy Mercy Hospitals have a history of caring for our community that goes back more than 100 years. We provide a broad range of medical and surgical services including minimally invasive and outpatient options. Our family of services includes the areas only inpatient oncology unit the Orthopedic Spine and Hand Center Family...


  • San Diego, CA, United States Comerica Bank Full time

    Environment Risk Officer IIIPrimary purpose is to provide technical review and deploy risk assessment techniques to evaluate environmental due diligence reports as part of Comerica’s environmental risk management (ERM) program. The purpose of the ERM program is to carefully balance the costs and risks of engaging in Comerica’s core real estate lending...


  • , CA, United States CommonSpirit Health Full time

    Founded by the Sisters of Mercy Mercy Hospitals have a history of caring for our community that goes back more than 100 years. We provide a broad range of medical and surgical services including minimally invasive and outpatient options. Our family of services includes the areas only inpatient oncology unit the Orthopedic Spine and Hand Center Family Birth...


  • , AZ, United States Maricopa Integrated Health System Full time

    As a Valleywise Utilization Review RN Coordinator, you are part of a multidisciplinary team providing exceptional care to our patients. As a Utilization Review RN Coordinator, you work under the direction of the Manager of Care Management as part of the inpatient Care Management Team. You are responsible for determining the appropriateness of patient status...


  • Bakersfield, CA, United States Common Spirit Full time

    Overview Founded by the Sisters of Mercy Mercy Hospitals have a history of caring for our community that goes back more than 100 years. We provide a broad range of medical and surgical services including minimally invasive and outpatient options. Our family of services includes the areas only inpatient oncology unit the Orthopedic Spine and Hand Center...

  • CLIN NURSE III

    1 day ago


    Harriman, TN, United States Covenant Health Inc. Full time

    Overview Registered Nurse I-III, Intermediate Care Unit/Stepdown PRN/OCC, Hours vary, Day Shift Roane Medical Center Overview: Proudly serving our community, Roane Medical Center is committed to your healthy future! Our state-of-the-art facility is equipped with modern technologies and expert staff to provide you the best possible patient care....

  • CLIN NURSE III

    2 days ago


    Harriman, TN, United States Covenant Health Inc. Full time

    Overview Registered Nurse I-III, Medical Surgical Unit PRN/OCC, Hours Vary, Night Shift Roane Medical Center Overview: Proudly serving our community, Roane Medical Center is committed to your healthy future! Our state-of-the-art facility is equipped with modern technologies and expert staff to provide you the best possible patient care. From...

  • Clin Nurse III

    2 days ago


    Harriman, TN, United States Covenant Health Inc. Full time

    Overview Registered Nurse I-III, Float Pool $5,000 Sign-on Bonus for experienced RNs Full Time, 72 Hours per Pay Period, Night Shift Roane Medical Center Overview: Proudly serving our community, Roane Medical Center is committed to your healthy future! Our state-of-the-art facility is equipped with modern technologies and expert staff to...

  • CLIN NURSE III

    1 day ago


    Harriman, TN, United States Covenant Health Inc. Full time

    Overview Registered Nurse I-III, Emergency Room $5,000 Sign-On Bonus for Experienced Candidates Full Time, 72 Hours per pay period, Shifts vary Roane Medical Center Overview: Proudly serving our community, Roane Medical Center is committed to your healthy future! Our state-of-the-art facility is equipped with modern technologies and expert...


  • Northridge, CA, United States Magnolia Gardens Skilled Nursing Facility Full time

    We are a skilled nursing facility looking for dynamic associates to join our clinical team and provide our residents with a best-in-class care experience! The IP Nurse is responsible for the implementation of the Infection Control program of the facility including antibiotic stewardship program. Employee will also be responsible in keeping facility staff and...


  • Bakersfield, CA, United States Dignity Health Full time

    **Overview** Founded by the Sisters of Mercy Mercy Hospitals have a history of caring for our community that goes back more than 100 years. We provide a broad range of medical and surgical services including minimally invasive and outpatient options. Our family of services includes the areas only inpatient oncology unit the Orthopedic Spine and Hand Center...


  • Phoenix, AZ, United States Maricopa Integrated Health System Full time

    As a Valleywise Utilization Review RN Coordinator, you are part of a multidisciplinary team providing exceptional care to our patients. As a Utilization Review RN Coordinator, you work under the direction of the Manager of Care Management as part of the inpatient Care Management Team. You are responsible for determining the appropriateness of patient status...


  • Phoenix, AZ, United States Maricopa Integrated Health System Full time

    As a Valleywise Utilization Review RN Coordinator, you are part of a multidisciplinary team providing exceptional care to our patients. As a Utilization Review RN Coordinator, you work under the direction of the Manager of Care Management as part of the inpatient Care Management Team. You are responsible for determining the appropriateness of patient status...