AIDS Healthcare Foundation

Managed Care Intern

US-CA-Los Angeles
Req No
2017-6913
Category
Managed Care
Type
Intern

Overview

AMAZING INDIVIDUALS WORKING FOR POSITIVE PEOPLE at AIDS Healthcare Foundation!

 

Does the idea of doing something that really makes a difference in people’s lives while being well-compensated intrigue you? Are you looking to work for an organization that encourages growth and success from each and every one of its employees?

 

If so, AIDS Healthcare Foundation is the place for you!

 

Founded in 1987, AIDS Healthcare Foundation is the largest specialized provider of HIV/AIDS medical care in the nation. Our mission is to provide cutting edge medicine and advocacy, regardless of ability to pay. Through our healthcare centers, pharmacies, health plan, research and other activities, AHF provides access to the latest HIV treatments for all who need them.

  

AHF’s core values are:

 

• Patient-Centered

• Value Employees

• Respect for Diversity

• Nimble

• Fight for What’s Right

 

 

STILL INTERESTED? Please continue!

 

Internship Overview

The Managed Care Division offers interns the opportunity to rotate through the different departments in the division to gain the knowledge how a managed care organization works. The intern will participate in the development and execution of new initiatives, such as a program to engage HIV-positive individuals with state, federal and community-based health care programs and provide direct support in the process. He or she will also assist various departments with implementation of existing initiatives, such as provider and enrollee survey satisfaction surveys.  This is a part-time paid internship varying from September 22, 2017 through December 15, 2017.

Responsibilities

Managed Care Division Overview

AHF’s Managed Care Division operates the organization’s Medicare and Medicaid/Medi-Cal HIV/AIDS specialty health plans in California and Florida, and disease management program in Florida. Plan enrollment is more than 4,700 enrollees. The Division also administers Ryan White programs in several counties where AHF operates Healthcare Centers by providing utilization and case management services. The Division performs several “back-office” functions for AHF’s Healthcare Centers, i.e., contracting activities with third party payers so that the clinics can accept a myriad of health insurance plans, claims adjudication for clinic-based HIV and STD testing services, credentialing of staff providers who work in AHF’s Healthcare Centers, etc.

 

Essential Duties and Responsibilities

Includes the following. Other duties may be assigned.

 

Administration/Special Projects:

  • Assist in the development of the new “We’ll Walk You Through It” program. This program, which is currently in development, will provide hands-on resources and support to HIV-positive individuals who need assistance in finding, accessing, applying for, and/or using existing health care coverage. Several components of this program include script writing, website development, process/flow development, program performance reporting, provider and community education, etc.

Quality Improvement Department:

  • Assist the National Quality Director in developing, analyzing, and reporting on medical and clinical quality improvement initiatives being conducted in AHF facilities nationwide. Quality improvement initiatives may include:
    • Consumer assessment survey analysis
    • Mental health data analysis
    • Quality Improvement training material development
    • Clinical measure improvement
    • QI contract deliverable analysis
    • Data stratification by demographic factors
    • Referral Follow-up with Specialist
    • Provider list validation
    • Data validation
    • Assistance with ICD10 Training
    • Health Effectiveness Data Improvement
    • Cultural Competency Research & Presentation
  • Collaborate with the National Quality Director or designee on quality improvement project design, data collection, tracking & analysis, and reporting.

Compliance Department:

  • Support the SharePoint Policy and Procedure project. Work includes revising editing and updating Division policy and procedures and setting up the storage scheme on the SharePoint application.
  • Assist the Department in the event of a Centers for Medicare and Medicaid Services (CMS) Program audit or another CMS financial audit by establishing a document tracking, indexing and sorting solution for audit readiness.

Member Services Department:

  • Develop management reports that summarizes and trends disenrollment rationale and enrollee complaint data that will be used to develop program improvement initiatives
  • Perform auditing activities to detect and report insufficiencies in enrollee enrollment files
  • Assist in the development of Member Services Department standard operating procedures.

Contracting and Provider Relations Department:

  • Assist with provider, hospital and ancillary services fee schedule verification and upload into the Division’s newly acquired provider data, claims adjudication, enrollee data and utilization management system and support provider data cleanup efforts.
  • Support Medicare plan service area expansion efforts through provider outreach and follow-up activities.

Qualifications

Qualifications

  • MPH with 3.0 GPA preferred.
  • Strong Microsoft Excel and PowerPoint skills.
  • Strong knowledge of Microsoft Access, SPSS or other database program preferred.
  • Pre-medical, research, or statistical experience would be helpful.
  • Work independently with strict confidentiality
  • Organizational skills/e-filing
  • Ability to conduct in a professional manner when use of company e-mail is required.

Mathematical Skills

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.


Reasoning Ability

Intermediate Skills: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

 

We at AIDS Healthcare Foundation believe that each individual is entitled to equal employment opportunities without regard to race, color, creed, gender, sexual orientation, gender identity, marital status, national origin, age, veteran status or disability. The right of equal employment opportunity extends to recruiting, hiring selection, transfer, promotion, training and all other conditions of employment.

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