What are the responsibilities and job description for the Supervisor, Facility Site Review RN position at L.A. Care Health Plan?
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.
Job Summary
The Supervisor of Facility Site Review RN conducts face-to-face visits with our high-membership physicians to provide feedback, data, and education on programs and facilitates changes to improve qualtiy of care and service to members. Conducts site reviews of PCPs sites to ensure quality FSR and physician compliance with Local, State, and Federal requirements. Supervises their designated team of staff assigned by the FSR Manager in the FSR department and is responsible for daily operational activities, including staffing, productivity and work quality and accuracy.
Duties
Conducts Full Scope Reviews, Site Review Surveys, Medical Record Review Surveys, Specialty Site Review Surveys, PARS assessments, Focused Reviews, Interim Onsite Reviews, Consultation/Educational Site visits, Investigative visits, HEDIS realted visits, and/or other appropraite site visits.
Conducts face-to-face visits with our high-membership physician sites to include the following: Provider feedback to providers on performance on HEDIS-related meausres and incentives performance; give providers health education materials and clinical tools to facilitate improved screening, preventive care, and chronic disease management; promote clinical quality improvements in practices; and document outcomes and issues of site visits for review and data gathering to the FSR Manager.
Act as the provider quality improvement liaison (PQIL) to assess and communicate issues and improvement opportunities identified during the physician site visit to the FSR Manager for resolution and a plan of action. Information gathered from provider sites will be submitted as a report and discussed with the FSR Manager at least bimonthly as appropriate.
Functions as the supervisor of designated staff in the Facility Site Reviewer department for daily operational activities, including but not limited to, training, coaching, counceling, disciplining, problem solving, staffing, productivity and work qualtiy and accuracy. Assist in the development and revisions of related policies and procedures. Provides input and assistance to designated staff in the Facility Site Reviewer department for quarterly performance evaluations.
Actively identifies and makes recommendations to the FSR Manager including ideas to improve the effectiveness and efficiency of departmental processes and health services functions. Assists and participates in the Annual Audit of Plan Partners delegated for FSR.
Communicates and coordinates information and findings from site visits between FSR Manager, internal and external staff and customers. Documents discussions and correspondence in FSR file as appropriate.
Performs other duties as assigned.
Education Required
Education Preferred
Experience
Required:
A minimum of 5-7 years experience in conducting Department of Health Care Services (DHCS) certified site reviews.
A minimum of 3-4 years of lead/supervisory experience.
Skills
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Additional Information
L.A. Care offers a wide range of benefits including
- Paid Time Off (PTO)
- Tuition Reimbursement
- Retirement Plans
- Medical, Dental and Vision
- Wellness Program
- Volunteer Time Off (VTO)
At L.A. Care, we value our team members’ safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.