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Partnership HealthPlan of California · 4 hours ago

Policy Analyst

Fairfield, CA

Full-time

Onsite

Mid Level

$94K/yr - $117K/yr

3+ years exp

Partnership HealthPlan of California is seeking a Policy Analyst responsible for drafting, editing, and maintaining policies and procedures. The role involves ensuring compliance with regulations and supporting leadership with research and operational readiness submissions.

Health CareInsuranceNon Profit

Culture & Values

Responsibilities

Performs policy research to analyze current and/or new regulations by applicable Partnership regulators and/or accrediting agencies (ex: DHCS, DMHC, CMS, NCQA, etc.)

Reviews timely draft and/or final All Plan Letters (APL), Policy Guides and/or other DHCS guidance for policy impact

Proactively identifies policies impacted by regulatory changes

In collaboration with stakeholders throughout the organization, drafts and prepares new policies

Performs document management by organizing, tracking and maintaining all policy updates and renewal cycles in PowerDMS

Prepares all policies and/or related materials for appropriate committees’ review and/or submission to associated regulatory or accrediting agencies

Supports Partnership audit and compliance readiness by submitting all materials timely

Serves as PowerDMS ‘Super User’ in the organization to effectively route policies with multi-departmental impacts to appropriate reviewers

Participates in audits with Partnership’s regulatory and/or accreditation bodies by preparing policies, documents and/or reports as needed

Communicates and coordinates across the organization to ensure that all active and current Partnership policies are available and reflected on Partnership websites

Makes strategic recommendation(s) to improve the accuracy, compliance, quality, performance and/or increase efficiencies within the organization

Assists in conducting risk assessments to identify potential areas of compliance vulnerability and areas at high risk of non-compliance; making recommendation for risk mitigation interventions

Conducts analysis, collects information, and evaluates impact of regulatory and compliance issues to inform auditing and monitoring activities

Analyzes the impact of new programs/benefits and efficacy of existing processes, policies, procedures and trainings

Consults with department leadership on a wide variety of compliance related subject matter areas as it relates to policies and procedures

Participates in special projects and assignments, as assigned

Attends all major committee meetings as policy and procedure advisor and key consultant on policy and procedure matters

Other duties as assigned

Qualification

Medi-Cal regulationsDHCS regulationsNCQA standardsHealth care experiencePolicy draftingDocument managementMicrosoft WordMicrosoft ExcelMicrosoft PowerPointCommunicationOrganizational skills

Required

Bachelor's degree in Liberal Arts, Communication, Business Administration, Health Care Administration, Political Science, or related field

3-4 years of experience in the health care field

Managed Care Experience Preferred, With Knowledge Of The Knox-Keene, Medicare, Medi-Cal, and Healthy Families regulations

Equivalent combination of education and experience

Working knowledge of Medi-Cal, Department of Health Care Services (DHCS) and/or National Committee on Quality Assurance (NCQA) regulations and standards

Highly proficient in applicable business software applications including PC usage, Microsoft Word, PowerPoint, Excel, Project

Typing speed of 40 wpm

Valid California Driver's License and proof of current automobile insurance compliant with Partnership's policies

Excellent oral and written communication skills

Excellent organizational skills with ability to prioritize assignments, maintain effective filing systems, and meet deadlines

Ability to work under minimal supervision and exercise independent judgment

Diplomacy and tact in handling sensitive information regarding personnel affairs as required

Ability to interact with executives and vendors effectively, handling all assignments with efficiency

Must be able to handle multiple tasks and meet deadlines

Excellent judgment

Ability to work within an interdisciplinary structure and function independently in a fast-paced environment while managing multiple priorities and deadlines

Strong Organizational Skills Required

Ability to use a computer keyboard

Ability to prioritize workload and initiate action to acquire needed information from professionals by phone

Ability to function effectively with frequent interruptions and direction from multiple team members

More than 50% of work time is spent in front of a computer monitor

Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs

Some travel required (up to 25%) including occasional overnight

Preferred

Managed Care Experience Preferred, With Knowledge Of The Knox-Keene, Medicare, Medi-Cal, and Healthy Families regulations

Experience with health plan audits preferred

Company

Partnership HealthPlan of California

Partnership HealthPlan of California is a non-profit community-based health care organization that contracts with the state to administer Medi-Cal benefits through local care providers to ensure Medi-Cal recipients have access to high-quality comprehensive cost-effective health care.

Founded in 1994

Fairfield, California, USA

1001-5000 employees