Operations Policy Specialist, Copy Editor

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🕒 July 16

🏄 California – Remote

🏄 California – Remote

💵 $91.7k - $128.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📝 Copywriter

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Gold Coast Health Plan

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2011

At Gold Coast Health Plan, we are driven to create the health plan of the future - today. We are disrupting the conventions of the health care industry by creating and applying leading-edge solutions to its many challenges.

📋 Description

• Serve as the primary owner and administrator of Operations policies and procedures maintained within the organization's policy management application. • Coordinate the creation, revision, review, approval, publication, and retirement of departmental policies and procedures. • Maintain an accurate inventory of Operations policies and procedures and ensure all required review cycles are completed timely. • Establish and maintain document version control, review schedules, approval workflows, and governance standards. • Monitor policy and procedure compliance with organizational requirements and established documentation standards. • Ensure all policies and procedures remain audit-ready and readily accessible. • Maintain knowledge of regulatory requirements affecting Operations functions, including Medi-Cal, D-SNP, Medicare Advantage, and managed care operations. • Analyze changes in regulatory, contractual, accreditation, and operational requirements and incorporate necessary updates into policies and procedures. • Ensure policies accurately reflect requirements issued by: DHCS CMS NCQA State and federal regulatory agencies Internal organizational governance bodies. • Support departmental readiness for audits, accreditation reviews, regulatory examinations, and compliance assessments. • Draft, edit, and maintain policy and procedure content using clear, concise, and consistent language. • Perform detailed copyediting and quality assurance reviews of Operations policies and procedures as well as JAMs, DLPs, and SOPs. • Ensure consistency in terminology, formatting, structure, readability, and policy language across all Operations documentation. • Validate policy content through collaboration with subject matter experts and operational leaders. • Recommend improvements to policy clarity, organization, and usability. • Facilitate policy review and update discussions with Operations leadership and subject matter experts. • Coordinate policy approvals and publication activities. • Provide consultation and editorial guidance regarding policy alignment for related operational documentation. • Serve as a departmental resource for policy interpretation, organization, and documentation standards.

🎯 Requirements

• Bachelor’s degree in Healthcare Administration, Business, English, Journalism, or a related field (or equivalent work experience) • 5-7 years of experience in health plan operations, vendor oversight, or compliance • Minimum 3-5 years of experience in Managed Healthcare Operations and/or Government Relations/Compliance must be added in lieu of a bachelor’s degree • Strong understanding of Medi-Cal and/or Medicare managed care requirements • Strong written and verbal communication skills • Ability to manage multiple priorities and meet deadlines • Data analysis and reporting skills required • Advanced computer skills in MS Office products • A valid and current Driver's License, Auto Insurance, and professional licensure(s) if travel is required.

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Professional development opportunities