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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #80Monday, April 14, 2025Provider Services Supervisor The Provider Contract Supervisor is responsible for overseeing the negotiation, analysis, and implementation of hospital, provider, and ancillary provider agreements as well as single case agreements across all lines of business. This role entails supervising a team of contract specialists, providing guidance and performance evaluations, ensuring compliance with regulatory requirements, and enhancing contract management to ensure department goals are met. This role w ...Read more about Provider Services SupervisorMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #78Monday, April 14, 2025Software Engineer- Core Systems We’re seeking a skilled Software Engineer to maximize the use and performance of core systems through tailored programming and system enhancements. This hands-on role requires strong expertise with Unix AIX platforms, embedded SQL, COBOL, Unix shell scripting, and DB2 databases. Familiarity with healthcare payer operations is highly recommended, particularly with Claims, Provider, and Member datasets, along with exposure to EDI transactions and their underlying st ...Read more about Software Engineer - Core SystemsMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #131Monday, April 14, 2025The Call Center Quality Monitoring Analyst is responsible for ensuring that customer interactions meet quality standards and deliver great customer experience. This includes evaluating and monitoring calls, providing feedback and coaching to agents, and helping improve call center processes. The analyst will also track key performance metrics, such as ACD reports, to identify trends and opportunities for improvement. Prepare internal and regulatory reports. Position overview Essential Functio ...Read more about Quality Monitoring Analyst (Hybrid)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #122Monday, April 14, 2025Under the direct supervision of the Quality Improvement Clinical Manager, the Quality Improvement Nurse monitors member health outcomes through internal and external data collection to determine effectiveness in maintaining safe care environments that meet regulatory requirements and to ensure members are receiving care that meets evidence-based standards. QI Nurse is responsible for collecting quality related data and reviewing medical records for HEDIS abstraction and overreads, Potential Qual ...Read more about Quality Improvement Nurse (RN)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #113Monday, April 14, 2025Project Manager- Business Systems Integration Provide operational and analytical support for small to medium sized projects. Assignments will be conducted by the incumbent with some degree of independence. Position overview Take lead, or assist, to investigate or to launch potential projects as directed relating to agency policy and operational initiatives across all product lines. Provide operational and analytical support for cross-departmental activities under all lines of business. Mana ...Read more about Project Manager IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #132Monday, April 14, 2025Are you detail-oriented, highly organized, and thrive in a fast-paced environment? Do you enjoy hands-on work and ensuring seamless operations behind the scenes? If so, we have the perfect opportunity for you! We are seeking a Production Support Assistant I to join our team in South San Francisco. This is a fully onsite position, providing critical mail, document processing, and printing services that keep our organization running smoothly. Why Join Us? Be part of a dynamic team that plays a v ...Read more about Production Support Assistant IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #136Monday, April 14, 2025General Description The Pediatric Community Health Worker (CHW) will provide care coordination, health education and navigation, and resource referral services that are medically necessary for HPSM’s infant and toddler members, as well as family members. This includes connecting members to primary care providers, addressing social determinants of health (SDOH), and providing or coordinating access to other needed services to improve members’ physical and mental health. The CHW will act as a liai ...Read more about Pediatric Community Health Worker - ONSITE & IN THE FIELDMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #121Monday, April 14, 2025This position is open to candidates based anywhere in California, with the understanding that occasional in-office meetings may be required. Plan and evaluate activities through the design and development of data/reports and the analysis and interpretation of data. This includes the development of database tools and analysis to produce data support for various company-wide programs and activities. Position overview Essential Functions: Analyze health management programs including data collect ...Read more about IT Health Data Analyst IIMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #134Monday, April 14, 2025We are seeking an experienced HRIS Analyst to oversee the daily operations of our HR Information Systems, ensuring data integrity, security, and optimal functionality. The HRIS Analyst will be responsible for implementing, configuring, and maintaining HRIS modules, collaborating on system integration, troubleshooting issues, and customizing the platform to align with HR processes. The role also includes developing analytics tools and dashboards that provide actionable insights, ensuring complian ...Read more about HRIS AnalystMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #83Monday, April 14, 2025Provide department-specific analysis and quality assurance to the Grievance and Appeals department. This includes analyzing data and processes to identify trends related to operational or quality issues; identifying and implementing process improvements; and supporting departmental training efforts. Position overview Utilizes G&A data to identify trends and root causes of repeat issues brought to the G&A unit; acts as an advocate for members, summarizing insights and clearly communicating qu ...Read more about Grievance and Appeals Quality AnalystMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #111Monday, April 14, 2025Join our team as the Director of Health Equity at Health Plan of San Mateo (HPSM), where you will play a pivotal role in advancing health equity and reducing health disparities within our member population. In this leadership position, you’ll be responsible for developing, implementing, and refining goals and initiatives related to health equity (HE), diversity, equity, inclusion, and belonging (DEIB). You’ll collaborate closely with internal teams and external partners to ensure that HPSM’s eff ...Read more about Director of Health EquityMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #84Monday, April 14, 2025Are you passionate about making a meaningful impact on health outcomes? Join our dynamic team as a Clinical Care Manager at Health Plan of San Mateo (HPSM), where you’ll play a pivotal role in transforming the lives of our members! In this role, you’ll conduct comprehensive assessments, design personalized care plans, and collaborate with network providers to ensure seamless care transitions. You’ll work across departments and with community partners to promote efficient resource utilization and ...Read more about Clinical Care Manager - TemporaryMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #129Monday, April 14, 2025Are you passionate about making a meaningful impact on health outcomes? Join our dynamic team as a Clinical Care Manager at Health Plan of San Mateo (HPSM), where you’ll play a pivotal role in transforming the lives of our members! In this role, you’ll conduct comprehensive assessments, design personalized care plans, and collaborate with network providers to ensure seamless care transitions. You’ll work across departments and with community partners to promote efficient resource utilization and ...Read more about Clinical Care ManagerMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #138Monday, April 14, 2025Only Open to Candidates in California General Description HPSM seeks a dedicated Senior Care Manager to collaborate with members and their care teams in assessing, developing, and managing personalized care plans that drive optimal health outcomes for individuals with complex medical and psychosocial needs. This role integrates evidence-based clinical guidelines to enhance the quality and efficiency of care delivery for health plan members. As a clinical subject matter expert, the Senior Care Ma ...Read more about Senior Clinical Care ManagerMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #139Tuesday, April 8, 2025Under direct supervision, respond to HPSM member and provider inquiries by telephone and other communication channels, providing members with comprehensive support regarding health plan benefits and services. Acts as the primary point of contact for members, delivering prompt, accurate, and courteous assistance via telephone and other communication channels, whether for general inquiries, concerns, or information requests about HPSM programs, services, eligibility or benefits. Position overvie ...Read more about Customer Service Navigator I Bilingual Spanish (Hybrid)More
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Req #106Monday, March 24, 2025Join our team as a Customer Service Navigator at Health Plan of San Mateo (HPSM), where you'll be the friendly voice providing vital support to our members and providers. In this role, you'll handle member and provider inquiries via phone and other communication channels, offering helpful information about health plan benefits, eligibility, and services. You’ll ensure our members receive clear, accurate, and timely assistance while maintaining a high standard of professionalism and compliance wi ...Read more about Customer Service Navigator IMore
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801 Gateway Blvd, South San Francisco, CA 94080, USA ● Virtual ● Req #137Friday, March 21, 2025General Description Under the direction of the Manager of Population Health, the Population Health Program Manager works to develop, implement, and evaluate various Population Health Management (PHM) programs and initiatives to improve health outcomes. The Population Health Program Manager uses data-driven approaches and facilitates cross-functional teams to develop population health interventions to reduce health disparities among HPSM’s member population. Qualifications The following represent ...Read more about Program Manager, Population Health (Remote)More