Current jobs related to Facility Site Review Nurse Specialist - San Francisco - San Francisco Health Plan
-
Product Review Specialist
1 day ago
San Diego, California, United States Product Review Jobs Full timeProduct Review SpecialistAre you interested in participating in market research opportunities with independent brands? As a Product Review Specialist with Product Review Jobs, you will have the chance to complete online studies and telephone interviews to provide valuable feedback on various products. Compensation varies per study, and you will be required...
-
Product Review Specialist
8 hours ago
San Mateo, California, United States Product Review Jobs Full timeProduct Review SpecialistAt Product Review Jobs, we are seeking a skilled Product Review Specialist to participate in market research opportunities with independent brands. As a Product Review Specialist, you will be responsible for completing online or phone studies to provide valuable feedback on various products. Compensation varies per study, with some...
-
Medical Claims Review Specialist
3 weeks ago
San Francisco, California, United States Medical Review Institute Full timeMedical Claims Review OpportunityMedical Review Institute of America (MRIoA) is seeking licensed physicians to join our esteemed peer review panel. As a Medical Claims Review Specialist, you will conduct independent, impartial reviews of medical documentation to ensure services provided align with recognized standards of care and current medical...
-
Product Review Specialist
6 days ago
San Diego, California, United States Product Review Jobs Full timeProduct Review Specialist OpportunityAt Product Review Jobs, we are seeking a Product Review Specialist to participate in market research opportunities with independent brands. As a Product Review Specialist, you will be responsible for completing online or phone studies to provide valuable feedback on various products.Key Responsibilities:Complete online or...
-
Product Review Specialist
6 days ago
San Mateo, California, United States Product Review Jobs Full timeProduct Review Specialist OpportunityAt Product Review Jobs, we are seeking a Product Review Specialist to participate in market research opportunities with independent brands. As a Product Review Specialist, you will be responsible for completing online or phone studies to provide valuable feedback on various products.Key Responsibilities:Complete online or...
-
Product Review Specialist
8 hours ago
San Diego, California, United States Product Review Jobs Full timeProduct Review SpecialistAs a Product Review Specialist with Product Review Jobs, you will have the opportunity to participate in market research studies for various independent brands. These studies are conducted online or via phone and typically take 15 minutes to an hour to complete. Compensation varies per study, but some studies can pay up to $500 per...
-
Product Review Specialist
6 days ago
San Mateo, California, United States Product Review Jobs Full timeCompensation: Varies per assignment, up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsAs a Product Review Specialist, you will participate in market research opportunities with independent brands via online or phone. These studies typically take 15 minutes, while telephone interviews may take 30-60 minutes each session. Compensation varies...
-
Clinical Utilization Review Specialist
1 week ago
San Jose, California, United States Acadia Healthcare Full timeSan Jose Behavioral Health is seeking an experienced Utilization Review Specialist to coordinate and assess the inpatient census for appropriate alternate health care service needs.The ideal candidate will have a degree in Nursing from an accredited college, and possession of a current nursing licensure (i.e. LVN, LPT, RN). Qualified candidates will have 3-5...
-
Plan Review Specialist
6 days ago
San Francisco, United States City of North Kansas Full timeJob SummaryWe are seeking a highly skilled Plan Review Specialist to join our team at the City of North Kansas. The successful candidate will be responsible for reviewing plans and construction documents to ensure compliance with City Codes.Key ResponsibilitiesReview plans, specifications, and calculations for building code compliance.Assist with the...
-
Utilization Review Nurse
1 month ago
San Francisco, California, United States Vivo HealthStaff Full timeJob Title: Utilization Review RNVivo HealthStaff is seeking a skilled Utilization Review RN to join our team in San Francisco. This hybrid position requires 1-2 days of on-site work per week.Job Summary:We are looking for a highly motivated and detail-oriented RN to collaborate with our healthcare team to ensure effective patient outcomes. The ideal...
-
Utilization Review Nurse
2 weeks ago
San Francisco, California, United States Vivo HealthStaff Full timeJob Title: Utilization Review RNVivo HealthStaff is seeking a skilled Utilization Review RN to join our team in San Francisco. This hybrid position requires 1-2 days of on-site work per week.Job SummaryWe are looking for a highly motivated and detail-oriented RN to collaborate with our healthcare team to ensure effective patient outcomes. The ideal candidate...
-
Facilities Maintenance Specialist
6 days ago
San Jose, California, United States Flagship Facility Services Full timeJob Summary: As a key member of the Flagship Facility Services team, the Facilities Maintenance Specialist will be responsible for ensuring the cleanliness and organization of our facilities. This role requires a detail-oriented individual who can maintain a high level of quality in their work.Key Responsibilities:Maintain a clean and organized workspace,...
-
Mobile Injury Response Specialist
2 weeks ago
San Francisco, California, United States On-Site Health & Safety Full timeJob Title: Mobile Injury Response SpecialistAre you a skilled EMT looking for a new challenge? We have an exciting opportunity for a Full-Time Mobile Injury Response Specialist to join our team at On-Site Health & Safety. As a Mobile Injury Response Specialist, you will be responsible for responding to injuries directly at the injured worker's job-site,...
-
Plan Review Specialist
2 weeks ago
San Francisco, United States City of North Kansas Full timeJob SummaryWe are seeking a highly skilled Plan Review Specialist to join our team at the City of North Kansas. The successful candidate will be responsible for reviewing plans and construction documents to ensure compliance with City Codes, providing excellent customer service, and coordinating the review and issuance of various types of planning...
-
Travel Nurse
2 weeks ago
San Diego, California, United States Healthcare Staffing Plus Full timeJob Title: Travel Nurse - Utilization Review SpecialistJob Summary: We are seeking a skilled Travel Nurse - Utilization Review Specialist to join our team at Healthcare Staffing Plus. As a key member of our healthcare team, you will be responsible for assisting in the development and maintenance of policies and procedures related to utilization management....
-
TV Installation Specialist
2 weeks ago
San Francisco, California, United States Geeks on Site Full timeJob OverviewGeeks On Site is seeking a skilled TV Installation Specialist to join our team. As a key member of our team, you will be responsible for providing top-notch TV mounting services to residential and commercial customers.Key Responsibilities:Conduct thorough assessments of customer needs and recommend tailored TV mounting solutions.Install various...
-
Travel Registered Nurse
2 weeks ago
San Diego, California, United States Healthcare Staffing Plus Full timeJob Title: Travel Registered Nurse - Utilization Review SpecialistHealthcare Staffing Plus is seeking a skilled Travel Registered Nurse - Utilization Review Specialist to join our team. As a Utilization Review Nurse, you will play a critical role in developing and maintaining policies and procedures for utilization management.Key Responsibilities:Collaborate...
-
Facilities Maintenance Specialist
6 days ago
San Francisco, California, United States Firefly Aerospace Full timeAbout Firefly AerospaceFirefly Aerospace is a leading provider of space transportation solutions. We are seeking a skilled Facilities Maintenance Specialist to join our team at Vandenberg Air Force Base. As a Facilities Maintenance Specialist, you will be responsible for the maintenance and repair of launch site buildings and support systems. This is a...
-
Nurse Specialist
6 days ago
San Bernardino, California, United States St. Elizabeth's Medical Center Full timeJob Summary:We are seeking a skilled Nurse Specialist to join our team at St. Elizabeth's Medical Center. As a key member of our Clinical Review team, you will be responsible for reviewing Client Development Evaluation Reports (CDER) of Diagnostic Elements and coding medical conditions. Your expertise will help us provide high-quality care to our...
-
Utilization Review Nurse
6 days ago
San Francisco, California, United States MarinHealth Medical Center Full timeAbout MarinHealth Medical CenterMarinHealth Medical Center is a leading healthcare provider in the North Bay, offering a unique blend of academic medicine and personalized care. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the right care at the right time.Job SummaryThe Utilization Review Nurse is responsible...
Facility Site Review Nurse Specialist
3 months ago
Reporting to the Manager of Facility Site Review (FSR), the Facility Site Review Nurse Specialist ensures SFHP is compliant with all DHCS (Department of Health Care Services) requirements regarding facility site, medical record, interim monitoring, and FSR-C (provider accessibility) reviews. The Nurse Specialist supports development, execution, and oversight of the FSR and FSR-C program.
Please note that while SFHP supports a hybrid work environment, this role will be required to be onsite and in-office a minimum of 4 days per month. This is a hybrid position, based in our Downtown San Francisco office. Facility Site Reviews are completed onsite at provider offices in and around San Francisco County. Travel is required to these locations to perform job duties.
Salary: $61.00 to $69.00 per hour
WHAT YOU WILL DO:
- Quality Oversight and Improvement
- Update and maintain provider resources needed to comply with DHCS requirements for all FSR types.
- Collaborate with FSR Team to strategically evaluate and improve internal FSR processes.
- Identify business process improvements that are aligned with and supportive of SFHP business goals and objectives. Provides thoughtful analyses and recommendations.
- Understand and support the SFHP mission and its overarching business goals and objectives.
- Report provider quality issues to the Chief Medical Officer, or clinician designee and present cases to Physician Advisory Committee, providing recommendations, and implementing follow-up actions.
- FSR team collaboration to maintain and update multiple quality and educational documents on SFHP website.
- Schedule, Oversight, and Assigning Site Review Activities
- Manage and maintain the FSR and FSR-C work plans, schedule, and shared health plan sites; enter FSR results into a data system.
- Coordinate and facilitate FSR-related meetings and trainings with multiple partners.
- Conduct and Scoring FSRs
- Conduct FSR (Facility Site Review Survey and Medical Record Review), FSR-C, D, E (PARS), and acupuncture site reviews.
- Issue Corrective Actions Plans (CAPS)
- Issue Corrective Action Plans (CAP); provide outreach, education, and follow-up to ensure CAP implementation and completion according to established timelines.
- Compliance Requirements
- Cultivate a working knowledge of relevant regulations and DHCS policy letters governing FSR, provider directories, and provider data maintenance.
- Participate in DHCS and DMHC audits of the Health Plan and follow up with providers on any corrective action plans (CAP) issued by the agencies.
WHAT YOU WILL BRING:
- Bachelor's degree in Nursing or similar area, or an equivalent combination of education and experience.
- Minimum 3 years of clinical experience.
- Minimum 3 years of experience in quality improvement or related clinical activity, preferred.
- Familiarity with managed care or Medi-Cal environment preferred.
- Active California Registered Nurse License or Physician without restrictions.
- DHCS certified site reviewer required or trained after hire.
WHAT WE OFFER:
- Health Benefits
- 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.
#LI-Hybrid
