Job Search
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #87Thursday, February 20, 2025Are you a compassionate leader with a passion for transforming behavioral health care? Join HPSM as a Behavioral Health Manager and make a lasting impact in our community! In this role, you’ll bridge the gap between physical and behavioral health services, lead innovative care management initiatives, and collaborate with a dedicated network of healthcare professionals. Your expertise will drive training programs, compliance initiatives, and quality improvements that directly benefit our members ...Read more about Behavioral Health ManagerMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #132Thursday, February 20, 2025Are you detail-oriented, highly organized, and thrive in a fast-paced environment? Do you enjoy hands-on work and ensuring seamless operations behind the scenes? If so, we have the perfect opportunity for you! We are seeking a Production Support Assistant I to join our team in South San Francisco. This is a fully onsite position, providing critical mail, document processing, and printing services that keep our organization running smoothly. Why Join Us? Be part of a dynamic team that plays a v ...Read more about Production Support Assistant IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #80Wednesday, February 12, 2025Provider Services Supervisor The Provider Contract Supervisor is responsible for overseeing the negotiation, analysis, and implementation of hospital, provider, and ancillary provider agreements as well as single case agreements across all lines of business. This role entails supervising a team of contract specialists, providing guidance and performance evaluations, ensuring compliance with regulatory requirements, and enhancing contract management to ensure department goals are met. This role w ...Read more about Provider Services SupervisorMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #131Thursday, February 6, 2025The Call Center Quality Monitoring Analyst is responsible for ensuring that customer interactions meet quality standards and deliver great customer experience. This includes evaluating and monitoring calls, providing feedback and coaching to agents, and helping improve call center processes. The analyst will also track key performance metrics, such as ACD reports, to identify trends and opportunities for improvement. Prepare internal and regulatory reports. Position overview Essential Functio ...Read more about Quality Monitoring Analyst (Hybrid)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #130Wednesday, February 5, 2025Make a difference in the lives of others! Join HPSM as a Senior Care Manager and play a vital role in improving healthcare outcomes for members with complex medical and psychosocial needs. You’ll work closely with members and their care teams to develop individualized care plans, coordinate services, and ensure the delivery of high-quality, efficient care. This role also serves as a clinical subject matter expert, providing guidance on complex cases and supporting program development within the ...Read more about Senior Clinical Care ManagerMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #129Tuesday, January 28, 2025Are you passionate about making a meaningful impact on health outcomes? Join our dynamic team as a Clinical Care Manager at Health Plan of San Mateo (HPSM), where you’ll play a pivotal role in transforming the lives of our members! In this role, you’ll conduct comprehensive assessments, design personalized care plans, and collaborate with network providers to ensure seamless care transitions. You’ll work across departments and with community partners to promote efficient resource utilization and ...Read more about Clinical Care ManagerMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #128Tuesday, January 28, 2025Join HPSM as a Care Management Specialist II and play a key role in supporting our members’ health journeys! In this role, you’ll work closely with a multidisciplinary team to coordinate care, assist with health assessments, and create tailored care plans to ensure our members receive the best possible care. You’ll be a vital part of the team, helping to connect members with resources, specialists, and community support while promoting a collaborative approach to care. We’re looking for someone ...Read more about Care Management Specialist IIMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #126Wednesday, January 22, 2025Health Plan of San Mateo Internship & Fellowship Program 2025 Application Due by March 1, 2025 The Health Plan of San Mateo (HPSM) is a local non-profit health plan that offers health coverage to San Mateo County's underserved population. We currently serve more than 150,000 county residents through several programs, with most of our members qualifying for coverage through Medi-Cal, the state’s Medicaid program. HPSM has more than 300 employees and partners closely with clinicians and community ...Read more about Internship/ Fellowship ProgramMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #119Friday, January 17, 2025This position is open to candidates based anywhere in California, with the understanding that occasional in-office meetings may be required. Join Our Team as a Provider Grants Program Manager at Health Plan of San Mateo (HPSM) Are you passionate about improving healthcare access and investing in provider networks? HPSM is seeking a Provider Grants Program Manager to develop, implement, and evaluate capacity funding programs that support our provider network. Reporting to the Director of Provider ...Read more about Program Manager, Provider GrantsMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #121Friday, January 17, 2025This position is open to candidates based anywhere in California, with the understanding that occasional in-office meetings may be required. Plan and evaluate activities through the design and development of data/reports and the analysis and interpretation of data. This includes the development of database tools and analysis to produce data support for various company-wide programs and activities. Position overview Essential Functions: Analyze health management programs including data collect ...Read more about IT Health Data Analyst IIMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #125Wednesday, January 15, 2025Ready to make an impact at the heart of healthcare operations? Join HPSM as an Executive Assistant and provide high-level administrative support to our Chief Medical Officer and other senior management staff. You’ll play a key role in streamlining operations, ensuring smooth communication, and supporting strategic initiatives that shape our organization’s success. As an Executive Assistant, you will handle a variety of administrative tasks, including managing calendars, preparing documents, and ...Read more about Executive AssistantMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #124Wednesday, January 15, 2025Customer Service Navigator I (Temporary) Under direct supervision, respond to HPSM member and provider inquiries by telephone and other communication channels, providing members with comprehensive support regarding health plan benefits and services. Acts as the primary point of contact for members, delivering prompt, accurate, and courteous assistance via telephone and other communication channels, whether for general inquiries, concerns, or information requests about HPSM programs, serv ...Read more about Customer Service Navigator I (TEMP)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #123Friday, January 10, 2025Claims Provider Representative I Under general supervision, help providers understand the policies and procedures in submitting claims, and assist in solving providers’ claim problems of a routine nature to ensure they are processed and paid on a timely basis. Position overview • Respond and handle high-volume calls via call center queue, voicemails, emails and faxes from medical providers and others, answering their questions and assisting in the resolution of issues relating to claims submissi ...Read more about Claims Provider Representative IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #122Thursday, January 9, 2025Under the direct supervision of the Quality Improvement Clinical Manager, the Quality Improvement Nurse monitors member health outcomes through internal and external data collection to determine effectiveness in maintaining safe care environments that meet regulatory requirements and to ensure members are receiving care that meets evidence-based standards. QI Nurse is responsible for collecting quality related data and reviewing medical records for HEDIS abstraction and overreads, Potential Qual ...Read more about Quality Improvement Nurse (RN)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #110Tuesday, January 7, 2025Support the Marketing and Communications (“MarComm”) Specialist and Manager by coordinating all aspects of a systematic workflow for marketing and communications requests. These include a high volume of member care plans as well as other marketing and communications projects. Reviews, obtains approval on, and processes requests; tracks projects and prepares status reports for stakeholders. Liaises with internal teams and external stakeholders to ensure timely completion of projects in compliance ...Read more about Marketing Coordinator - Temporary (6 Months)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #120Monday, December 23, 2024Program Specialist I, Member Services Providing technical support acts as a liaison between regulatory agencies, community partners and health providers. Position overview Provide technical support to ensure that eligibility files for are processed correctly in HPSM’s claims/eligibility system. Ensure timely and accurate participant and member eligibility processing. Collaboratively work with staff at several agencies, community partners and health providers. May function as primary point of ...Read more about Program Specialist I, Member ServicesMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #83Wednesday, December 18, 2024Provide department-specific analysis and quality assurance to the Grievance and Appeals department. This includes analyzing data and processes to identify trends related to operational or quality issues; identifying and implementing process improvements; and supporting departmental training efforts. Position overview Utilizes G&A data to identify trends and root causes of repeat issues brought to the G&A unit; acts as an advocate for members, summarizing insights and clearly communicating qu ...Read more about Grievance and Appeals Quality AnalystMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #117Wednesday, December 11, 2024The Provider Contracts Manager, reporting to the Manager of Provider Services Operations, is responsible for managing contracting activities for the HPSM provider network. This includes drafting and negotiating contracts, maintaining a contracts database, ensuring compliance with regulatory requirements, and analyzing rate scenarios. The role involves collaborating with internal and external stakeholders, supporting audit activities, and providing recommendations for system improvements. Require ...Read more about Provider Contracts ManagerMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #84Tuesday, November 19, 2024Are you passionate about making a meaningful impact on health outcomes? Join our dynamic team as a Clinical Care Manager at Health Plan of San Mateo (HPSM), where you’ll play a pivotal role in transforming the lives of our members! In this role, you’ll conduct comprehensive assessments, design personalized care plans, and collaborate with network providers to ensure seamless care transitions. You’ll work across departments and with community partners to promote efficient resource utilization and ...Read more about Clinical Care Manager - TemporaryMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #113Thursday, November 14, 2024Project Manager- Business Systems Integration Provide operational and analytical support for small to medium sized projects. Assignments will be conducted by the incumbent with some degree of independence. Position overview Take lead, or assist, to investigate or to launch potential projects as directed relating to agency policy and operational initiatives across all product lines. Provide operational and analytical support for cross-departmental activities under all lines of business. Mana ...Read more about Project Manager IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #78Friday, November 1, 2024Software Engineer- Core Systems We’re seeking a skilled Software Engineer to maximize the use and performance of core systems through tailored programming and system enhancements. This hands-on role requires strong expertise with Unix AIX platforms, embedded SQL, COBOL, Unix shell scripting, and DB2 databases. Familiarity with healthcare payer operations is highly recommended, particularly with Claims, Provider, and Member datasets, along with exposure to EDI transactions and their underlying st ...Read more about Software Engineer - Core SystemsMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #111Friday, October 25, 2024Join our team as the Director of Health Equity at Health Plan of San Mateo (HPSM), where you will play a pivotal role in advancing health equity and reducing health disparities within our member population. In this leadership position, you’ll be responsible for developing, implementing, and refining goals and initiatives related to health equity (HE), diversity, equity, inclusion, and belonging (DEIB). You’ll collaborate closely with internal teams and external partners to ensure that HPSM’s eff ...Read more about Director of Health EquityMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #106Wednesday, October 9, 2024Join our team as a Customer Service Navigator at Health Plan of San Mateo (HPSM), where you'll be the friendly voice providing vital support to our members and providers. In this role, you'll handle member and provider inquiries via phone and other communication channels, offering helpful information about health plan benefits, eligibility, and services. You’ll ensure our members receive clear, accurate, and timely assistance while maintaining a high standard of professionalism and compliance wi ...Read more about Customer Service Navigator IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #103Thursday, October 3, 2024Join our team as a Customer Service Navigator at Health Plan of San Mateo (HPSM), where you'll be the friendly voice providing vital support to our members and providers. In this role, you'll handle member and provider inquiries via phone and other communication channels, offering helpful information about health plan benefits, eligibility, and services. You’ll ensure our members receive clear, accurate, and timely assistance while maintaining a high standard of professionalism and compliance wi ...Read more about Customer Service Navigator IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #95Tuesday, September 24, 2024Join our team as a Claims Examiner at Health Plan of San Mateo (HPSM), where you’ll play a key role in reviewing and resolving claims for over 160,000 members. In this position, you’ll tackle everything from medical and dental claims to inpatient/outpatient, supplies, and DME, all while ensuring they’re processed accurately and within established timeframes. You’ll research claims, communicate with providers, and resolve issues by making decisions to pay, deny, or adjust claims. Additionally, yo ...Read more about Claims ExaminerMore