Facility Site Review Coordinator II

L.A. Care Health Plan•Los Angeles, CA

7d•$50,216 - $75,324

About The Position

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.

Requirements

High School Diploma/or High School Equivalency Certificate
At least 1 year of experience and knowledge of facility site review processes and requirements; or 1 year of healthcare experience in a similar field; or 1 year of coordination experience; or 1 year in an assistant/receptionist position.
Excellent computer skills, MS Word, Access, and Excel.
Excellent organizational skills.
Proficient in problem solving.
Ability to handle multiple priorities.

Nice To Haves

Associate's Degree

Responsibilities

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.
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.
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.
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.
Coordinate Nurse Reviewers scheduled audits and appropriate site review packets for PCP scheduled sites and other appropriate types of audits.
Review, prepare, and coordinate with Nurse Reviewers periodic full scope reviews due for a site review three months prior to the expiration date.
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.
Perform other duties as assigned.