Address
Form of workSalary 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 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 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, prepare and send pre-audit packets to providers, monitor incoming emails from Plan Partners to enter FSRs scheduled via FSR scheduling website, enter new provider data to website as requested by Provider Network Operations (PNO), address 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%)
Duties Continued
Education Required
High School Diploma/or High School Equivalency Certificate
Education Preferred
Associate's Degree
Experience
Required:
At least 0-1 years of experience and knowledge of Facility Site Review processes and requirements; or 1 years of healthcare experience in a similar field; or 1 years of coordination experience; or 1 years in an assistant/receptionist position.
Skills
Required:
Excellent computer skills, MS Word, Access, and Excel.
Excellent organizational skills.
Proficient in problem solving.
Ability to handle multiple priorities.
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
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 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, prepare and send pre-audit packets to providers, monitor incoming emails from Plan Partners to enter FSRs scheduled via FSR scheduling website, enter new provider data to website as requested by Provider Network Operations (PNO), address 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%)
Duties Continued
Education Required
High School Diploma/or High School Equivalency Certificate
Education Preferred
Associate's Degree
Experience
Required:
At least 0-1 years of experience and knowledge of Facility Site Review processes and requirements; or 1 years of healthcare experience in a similar field; or 1 years of coordination experience; or 1 years in an assistant/receptionist position.
Skills
Required:
Excellent computer skills, MS Word, Access, and Excel.
Excellent organizational skills.
Proficient in problem solving.
Ability to handle multiple priorities.
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)
