Job Search
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #112Thursday, November 21, 2024This Compliance Coordinator is responsible for supporting the preparation of survey documentation, which includes tasks such as tagging and bookmarking documents, updating compliance statements, and managing the documentation tracker. Position overview Prepare and organize survey documentation by tagging and bookmarking both existing and updated materials to ensure easy access and reference. Review and verify survey documentation tags and bookmarks to ensure they meet established standards fo ...Read more about Compliance Coordinator (Temp)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #65Tuesday, November 19, 2024The Speech and Language Pathologist will conduct assessments, provide recommendations, organize, and implement medically necessary services for youth in San Mateo County with HPSM insurance. This position is primarily in person and co-located at the Tower Street School in San Mateo. Position overview Process HPSM network referrals and complete the SLP assessment process to identify communicative and speech disorders through screening and testing. Make recommendations and implement an individ ...Read more about Speech and Language Pathologist (TEMP)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #84Tuesday, November 19, 2024Are you passionate about making a meaningful impact on health outcomes? Join our dynamic team as a Clinical Care Manager and play a pivotal role in transforming the lives of our HPSM members! In this role, you'll conduct comprehensive assessments, design personalized care plans, and lead interdisciplinary case conferences with network providers. Your work will ensure seamless care transitions and efficient resource utilization by collaborating across departments, providers, community programs, a ...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 #112Friday, October 25, 2024This Compliance Coordinator is responsible for supporting the preparation of survey documentation, which includes tasks such as tagging and bookmarking documents, updating compliance statements, and managing the documentation tracker. Position overview Prepare and organize survey documentation by tagging and bookmarking both existing and updated materials to ensure easy access and reference. Review and verify survey documentation tags and bookmarks to ensure they meet established standards fo ...Read more about Compliance Coordinator (Temp)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #111Friday, October 25, 2024The Director of Health Equity reports directly to the Chief Health Officer (CHO) and works collaboratively to advance health equity and reduce health disparities among our member population. In addition, this leader will advance internal efforts to support a diverse workforce and foster an equitable and inclusive workplace. The director of Health Equity will develop, implement, analyze, and refine HPSM goals and objectives related to health equity (HE), diversity, equity, inclusion, and belongin ...Read more about Director of Health EquityMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #110Friday, October 25, 2024Support 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 #109Wednesday, October 23, 2024Quality Improvement Nurse Overreader HEDIS (RN) (TEMP) Under 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 reco ...Read more about Quality Improvement Nurse Overreader HEDIS (RN) (TEMP)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #83Wednesday, October 23, 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 #107Thursday, October 10, 2024This role is responsible for providing lead administrative support and assistance to the Integrated Care Management team. Primary focus is responding to integrated care management requests, data entry of medical records, data reporting, member screening and outreach, maintenance of tracking census and reports, and assistance in linking members to appropriate benefits and services. Position overview Process ICM Care Management team requests for member outreach, screening, education, referrals ...Read more about Integrated Care Program SpecialistMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #106Wednesday, October 9, 2024Under 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, services, eligibility or benefits. Position overvie ...Read more about Customer Service Navigator IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #105Tuesday, October 8, 2024Claims Examiners review and resolve claims within established timeframes using the appropriate program policies and procedures. This ensures that Health Plan of San Mateo (HPSM), a community-based nonprofit, accurately processes the claims submitted by our network providers for our more than 160,000 members. There are three classification levels for the Claims Examiner position (I, II and III) that correspond to candidates’ years of experience, level of knowledge and demonstrable skills. Candida ...Read more about Claims Examiner IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #101Monday, October 7, 2024Assess healthcare data sets to measure the costs, impact and value of healthcare programs, then summarize results for financial reporting and subject matter experts (SMEs). By providing high-quality and thoughtful financial data, Healthcare Financial Analysts help internal SMEs make informed decisions about how to measure and manage the care of Health Plan of San Mateo’s (HPSM’s) 140,000-plus members. Data analysts who want to improve their skills through on-the-job training, make consistent con ...Read more about Healthcare Financial AnalystMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #104Monday, October 7, 2024The Manager of Community Care is responsible for the development, implementation, relationship management, oversight, and evaluation of key HPSM partnerships and community benefits targeted to improve health outcomes and member experience in alignment with HPSM’s model of care and strategic initiatives. This position directs and supervises a team of Community Health Workers (CHWs) delivering services to HPSM’s pediatric population. Position overview Plans and implements programs to meet the s ...Read more about Manager of Community CareMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #103Thursday, October 3, 2024Under 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, services, eligibility or benefits. Position overvie ...Read more about Customer Service Navigator IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #102Monday, September 30, 2024Under the general guidance from the CareAdvantage Manager, the CareAdvantage Trainer is responsible for assessing and fulfilling the training needs of the CareAdvantage Department. This includes designing, developing, implementing, evaluating, and delivering staff development programs including general orientation, job-specific orientation, one-on-one support, and refresher training programs for the CareAdvantage team. Position overview Essential Functions: Develop, organize, maintain, evalu ...Read more about CareAdvantage TrainerMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #100Wednesday, September 25, 2024Responsible for engaging with internal and external stakeholders to develop, manage, and improve behavioral health programs related to HPSM’s members. The Program Manager provides operational support and relationship management for ongoing contracted, provider and vendor delivered programs with a focus on quality, accessibility, sustainability, and integration within HPSM. Position overview Manage program(s) from initiation through delivery and monitor for continuous improvement. Serve as pri ...Read more about Program Manager, Behavioral HealthMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #99Wednesday, September 25, 2024The IT Configuration Manager is responsible for leading the IT Configuration Unit, optimizing core system configurations, and ensuring compliance with relevant standards. The role involves collaboration with various teams to identify needs, design, and implement the best configuration solutions to meet evolving business requirements of the organization Position overview Manage the IT Configuration Unit, providing direction, oversight, and support to team members. Conduct planning on a multi-y ...Read more about IT Configuration ManagerMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #95Tuesday, September 24, 2024Claims Examiners review and resolve claims within established timeframes using the appropriate program policies and procedures. This ensures that Health Plan of San Mateo (HPSM), a community-based nonprofit, accurately processes the claims submitted by our network providers for our more than 160,000 members. There are three classification levels for the Claims Examiner position (I, II and III) that correspond to candidates’ years of experience, level of knowledge and demonstrable skills. Candida ...Read more about Claims ExaminerMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #98Tuesday, September 17, 2024The Pediatric Community Health Worker (CHW) will provide care coordination, health education and navigation, and care management services that are medically necessary for HPSM’s infant and toddler members, as well as members in their families. These include connecting members to primary care, addressing social determinants of health (SDOH), and providing or coordinating access to other needed services to improve members’ physical and mental health. The CHW will act as a liaison collaborating dir ...Read more about Pediatric Community Health WorkerMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #97Friday, September 13, 2024The Care Management Specialist III coordinates with a multidisciplinary team care to provide person-centered interventions to health plan members, through effective partnerships with their caregivers/families, community resources, and their physician. He or she facilitates shared decision-making within and across settings to achieve coordinated high-quality care that is collaborative and timely Position overview Function as part of a multidisciplinary care team to manage plan members utilizin ...Read more about Care Management Specialist IIIMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #96Friday, September 13, 2024The Care Management Specialist II coordinates with a multidisciplinary team care to provide person- centered interventions to health plan members, through effective partnerships with their caregivers/families, community resources, and their physician. He or she facilitates shared decision- making within and across settings to achieve coordinated high-quality care that is collaborative and timely. Position overview Independently handle requests for care coordination, assessing the member’s nee ...Read more about Care Management Specialist IIMore
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Health Plan of San Mateo, 701 Gateway Blvd., South San Francisco, CA, USA ● Virtual ● Req #93Wednesday, September 4, 2024As a Grievance and Appeals Coordinator, you will follow procedures to resolve complaints filed by HPSM members and their representatives, ensuring that their concerns are addressed promptly and effectively. You will also provide backup support for our Member Services and CareAdvantage teams. Bring your passion to a rewarding career that makes a real difference in the community. A remote work option is available for California residents. This position is not eligible for sponsorship. Position ov ...Read more about Grievance & Appeals Coordinator IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #90Friday, August 16, 2024Member Services Call Center Supervisor Oversee, supervise, and direct the day-to-day activities of assigned staff and unit in a call center environment while maintaining own case load Position overview Essential Functions: Perform other duties as assigned. Accomplish staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and implementing corrective action steps when necessary; coordinating, and enforcing systems, policies, proc ...Read more about MS Supervisor IMore