Plan Design Specialist jobs in San Francisco, CA
Plan Design Specialist works closely with clients to design group health, dental and/or life insurance plans to create an overall benefit package. Works alongside underwriters, but is not an underwriter role. Being a Plan Design Specialist monitors and analyzes cost trends. May handle more complex plan design. Additionally, Plan Design Specialist requires a bachelor's degree or its equivalent. Typically reports to a supervisor or manager. The Plan Design Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Plan Design Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Recently Added Plan Design Specialist jobs
Compliance Specialist
- CCHP Health Plan
-
San Francisco, CA
FULL_TIME
-
Requisition #
20398
Location
San Francisco Bay AreaEmployment Type
Full Time, Hybrid (2 Days in Office)Position Summary
The Compliance Specialist at CCHP supports the efforts of the Compliance Officer to improve CCHP’s public presence and to provide excellent service to our existing and potential members, fellow employees, and business partners. With strong organizational skills, the Compliance Specialist assists the Compliance Officer in achieving the goals and objectives; identifies and resolves a variety of issues related to regulatory issues; maintains basic commercial regulatory files; develops and facilitates marketing materials; and prepares and submits Medicare/commercial marketing materials to federal and state regulators. This person has direct, daily contact with CCHP and Chinese Hospital managers, and other office staff persons.Essential Duties & Responsibilities
- Assists with regulatory filings into the Department of Managed Health Care (DMHC) and Centers for Medicare and Medicaid Services (CMS) protocols.
- Assists the Compliance Officer to monitor the day-to-day compliance activities.
- Assists with conducting the compliance risk assessment and assist with internal audit and monitoring activities.
- Coordinates and/or manages the response to, and investigation of, privacy and security incidents and breaches of protected information; provide guidance or technical assistance and follow-up on mitigation and corrective action activities.
- Coordinates activities related to the implementation of compliance and privacy mandates (i.e., Federal and State laws and regulations including privacy and FWA risk assessments, audits, and the preparation of reports / metrics / dashboards.
- Extracts data, notices, as required, in DMHC Systems (e.g., Timely Access Reporting, etc.).
- Under the supervision of the Compliance Officer, research, analyze, and interpret laws, regulations, and contracts; develop, review, and update policies and procedures; conduct routine or focused reviews for adherence to State, and local (Covered California) regulatory and contractual requirements, as well as organizational needs. – DMHC & DHCS /State and Accreditation (NCQA).
- Assists organization with internal, external, and regulatory audits.
- Provide guidance and assistance to CCHP departments in statutory and regulatory requirements
- Assists the Compliance Officer with responding to compliance hotline reports, department calls, reports of non-compliance, or other contacts. Assist with strategizing potential solutions and their implementation, including but not limited to compliance review spot-checks, training sessions, or policy revisions.
- Performs ongoing compliance reviews to detect or confirm compliance violations.
- Proactively cultivates and maintains strong, positive working relationships.
- Maintains confidentiality of all information related to members, medical staff, employees, integrity issues, audits, and, as appropriate, other information.
- Assists with or leads the development of compliant marketing materials.
- Assists in performing presentations on educational trainings.
- Stays knowledgeable and up-to-date with compliance of regulatory requirements.
- Follows established and newly implemented changes in departmental policy.
- Accepts and performs other duties as assigned.
Qualifications
- Bachelors degree or equivalent in Business Administration, Health Care or related field
- Two years prior experience in a health care environment
- Strong interpersonal and communication skills and ability to work effectively with a wide range of constituencies
- Excellent time management, organizing and coordinating skills
- Ability to make rational judgments on sensitive and confidential issues
- Ability to set and change priorities quickly and as the situation warrants
- Strong skills in Microsoft applications including MS Office: Word, Excel, PowerPoint, and Outlook
- Follows directions carefully and completely
- Works efficiently to maximize productivity
- Strong written and verbal skills
- Professional in manner and appearance
Physical requirements
- Able to lift up to 30 pounds
- Use proper body mechanics when handling equipment
- Standing, walking and moving 50% of the day.
Compliance requirements
Complies with CCHP Compliance Handbook including Code of Ethics and all statutes, regulations, guidelines applicable to federal and state programs. Responsibilities include, following the guidelines and reporting suspected violations of any statute, regulations, agreements or guidelines applicable to all healthcare programs.Base Pay Scale
Starting at $24.20/hour – $38.61/hourThe salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage. - 29 Days Ago
Compliance Specialist II
- Health Plan of San Mateo
-
South San Francisco, CA
FULL_TIME
- General Description Under the general direction of the Compliance Manager, the Compliance Specialist II gathers data for regulatory reports, performs technical analysis, conducts regulatory research a...
- 6 Days Ago
Quality Review Navigation Specialist
- SF Health Plan
-
San Francisco, CA
FULL_TIME
- Established in 1997, San Francisco Health Plan (SFHP) is an award winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-inco...
- 1 Month Ago
Behavioral Health Care Management Specialist III - Bilingual Spanish
- Health Plan of San Mateo
-
South San Francisco, CA
FULL_TIME
- As a bilingual Behavioral Health Care Management Specialist, you will serve as a member liaison, providing vital assistance with care management for HPSM members with behavioral health treatment needs...
- 5 Days Ago
Wholesale Operations Specialist
- Peak Design
-
San Francisco, CA
FULL_TIME
- ABOUT USPeak Design makes radical, meticulously-engineered gear for detail-obsessed people. Our backpacks, travel bags, camera gear, and phone accessories are used dang-near everywhere. If you’ve visi...
- 5 Days Ago
Sustainable Design Specialist
- HOK Group, Inc.
-
San Francisco, CA
FULL_TIME
- Sustainable Design Specialist designs buildings and spaces that respond to the needs of people and the environment. Our designers are rooted in technical excellence, driven by imagination and focused ...
- 11 Days Ago
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0 Plan Design Specialist jobs found in San Francisco, CA area
Design Technology BIM Specialist
- BDE Architecture
-
San Francisco, CA
- Job Summary: The BDE definition of a BIM Specialist (Design Technology Specialist by AIA definition) is someone who work...
- 4/18/2024 12:00:00 AM
Design Technology BIM Specialist
- BDE Architecture
-
San Francisco, CA
- Job Summary: The BDE definition of a BIM Specialist (Design Technology Specialist by AIA definition) is someone who work...
- 4/18/2024 12:00:00 AM
Graphic Design Specialist
- Pleasanton Tool & Mfg
-
Pleasanton, CA
- We are seeking a dedicated graphic designer to join our growing company. You will collaborate with other designers to cr...
- 4/18/2024 12:00:00 AM
Graphic Design Specialist
- smartdept. inc.
-
Sunnyvale, CA
- smartdept. is searching for a Graphic Design Specialistfor a medical appliance development client located in Sunnyvale, ...
- 4/18/2024 12:00:00 AM
Client Relationship Marketing Manager (LOA Cover)
- HelloKindred
-
San Francisco, CA
- Who is HelloKindred? HelloKindred are specialists in staffing marketing, creative and technology roles, offering a range...
- 4/18/2024 12:00:00 AM
Customer Experience Specialist III
- HeartCentrix
-
San Francisco, CA
- Job Description Job Description Job Description: Partner with Program Lead to support 2-3 acquisitions of new companies ...
- 4/18/2024 12:00:00 AM
Accounts Payable Specialist
- The Friendship House Association of American Indians
-
San Francisco, CA
- Job Description Job Description Summary: The AP/Payroll Specialist, under the direct supervision of Accounting Manager i...
- 4/18/2024 12:00:00 AM
Graphic Design Specialist 2/3
- Maxonic
-
Sunnyvale, CA
- Maxonic maintains a close and long-term relationship with our direct client. In support of their needs, we are looking f...
- 4/17/2024 12:00:00 AM
About San Francisco, California
San Francisco is located on the West Coast of the United States at the north end of the San Francisco Peninsula and includes significant stretches of the Pacific Ocean and San Francisco Bay within its boundaries. Several picturesque islands—Alcatraz, Treasure Island and the adjacent Yerba Buena Island, and small portions of Alameda Island, Red Rock Island, and Angel Island—are part of the city. Also included are the uninhabited Farallon Islands, 27 miles (43 km) offshore in the Pacific Ocean. The mainland within the city limits roughly forms a "seven-by-seven-mile square", a common local collo...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Plan Design Specialist jobs
$92,548 to $125,435
San Francisco, California area prices
were up 4.5% from a year ago
were up 4.5% from a year ago
What does a Plan Design Specialist do?
Plan Design Specialist in Birmingham, AL
SmithGroup creates exceptional design solutions for healthcare, science and technology organizations, higher education and cultural institutions, urban environments, diverse workplaces, mixed-use and waterfront developments, and parks and open spaces.
December 13, 2019