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Health Net · 5 days ago

Senior Health Equity Specialist

California, United States

Full-time

Hybrid

Senior Level

$70K/yr - $126K/yr

5+ years exp

Health Net is a diversified national organization seeking a Senior Health Equity Specialist to ensure compliance with regulations and contractual obligations related to culturally and linguistically appropriate services and health equity. The role involves developing strategies, managing programs, and representing the health plan to various stakeholders while identifying and implementing health equity initiatives.

Financial ServicesHealth CareHealth InsuranceInsurancePersonal HealthWellness

Responsibilities

Implements and manages programs in compliance with contracts and regulations and monitors ongoing program performance to maintain compliance

Develops strategies and policies to deliver C&L services and maintain compliance with regulatory and contractual obligations

Develops, interprets and communicates policies, procedures, regulations and standards

Develops California State Health Programs (Medi-Cal) contract content for C&L services, for Medi-Cal, Healthy Families, and Healthy Kids products

Prepares P&P’s for committee adoption

Implements activities to meet regulatory obligations

Monitors compliance with California regulations and State Health Programs contractual obligations

Assesses operational gaps compared to new standards and makes recommendations to senior management

Represents Health net to Regulators and Accreditation Agencies, demonstrating the provision of culturally & linguistically appropriate health care services

Liaisons between community coalitions, California and local regulators, vendors, accrediting bodies and Health Net senior management to increase knowledge of new C&L standards and ensures contract requirements, goals and regulatory are met

Monitors/evaluates translation services and interpreter services

Evaluates externally translated materials from vendors and provides recommendations to vendor management/contracting

Identifies and resolves compliance issues/quality issues related to translating material

Identifies and resolves compliance issues/quality issues related to the provision of interpreter services

Reviews the translation process and translated materials for improvement opportunities

Manages Community Advisory Committees

Develops regional goals, outcomes and objectives for Committees

Represents and articulates local or regional needs to senior management committees

Develops C&L programs to enhance access to care for members and providers based on geographic, cultural, and linguistic data

Develops teaching to standard modules for associates

Develops teaching to standard modules for providers

Reviews member and provider material for cultural and linguistic appropriateness

Monitors grievance and appeals processes for C&L issues

Proactively identifies areas of improvement for the department and participates in development of improvement plans

Qualification

Health EquityCulturally Appropriate ServicesRegulatory ComplianceProgram ManagementPolicy DevelopmentAnalytical SkillsCommunity EngagementCommunication Skills