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Senior Manager, Enhanced Care Management

2 months ago


San Francisco, United States San Francisco Health Plan Full time

Reporting to the Director of Care Management, the Senior Manager, Enhanced Care Management & Community Supports will oversee the operation of the CalAIM Enhanced Care Management (ECM) and Community Supports (CS) benefits. You will support the implementation of new ECM populations of focus and Community Supports, as part of a whole-system, person-centered delivery system reform to improve quality and care to members. You will support key decisions to ensure that goals are accomplished within the constraints of budget, schedule, and customer expectations. As a subject matter expert for ECM and CS, you will also oversee regulatory audits and will build relationships critical to the success of these benefits, including working with the SF Department of Public Health, contracted providers, and partners.

Please note that while SFHP supports a hybrid work environment, this role will be required to be onsite and in-office a minimum of 4 days per month. This position is based in our Downtown San Francisco office.

Salary: $126,000 to $142,000

WHAT YOU WILL DO:

  • Support the development and execution of short-term strategy for implementation of the ECM and CS benefits, and contribute to long-term strategy for whole-person and whole-system care for high-need members.
  • Responsible for the project coordination, including planning and sequencing work, setting milestones and deadlines, assigning responsibilities, facilitating workgroups, monitoring progress, and reporting project status.
  • Drive contracting, coordination, onboarding and management of ECM/CS network and programs.
  • Support operational compliance and reporting to satisfy and exceed state and federal standards.
  • Contribute to planning and implementation phases of new or enhanced benefits, or pilots that will improve implementation of CalAIM.
  • Provide direct guidance to the ECM & CS staff, thereby creating a high-performing team through coaching individuals to set and exceed individual and department goals, providing opportunities for staff in self-learning and skill development and promoting a healthy team atmosphere.
  • Manage staff on operational matters and proposes solutions to operational issues and improvements related to services provided to members by other SFHP departments, vendors/contractors, and provider networks.
  • Ensure that related policies and procedures necessary to operate the department comply with regulatory and accreditation requirements and are in place and updated no less than annually.

WHAT YOU WILL BRING:

  • Bachelor's degree in policy, administration, or health care related field, or equivalent work experience.
  • 3 or more years of experience of supervisory or management experience.
  • 3 or more years of experience collaborating with external stakeholders to achieve shared goals.
  • Experience in delivery and implementation of large-scale health plan initiatives.
  • Knowledge of Health Plan Core functions of Medi-Cal and CalAIM.
  • Knowledge of Health Plan/ Integrated Delivery system models of case management and care coordination best practices.

WHAT WE OFFER:

  • Health Benefits
    • Medical: You’ll have a choice of medical plans, including options from Kaiser and Blue Shield of California, heavily subsidized by SFHP.
    • Dental: You’ll have a choice of a basic dental plan or an enhanced dental plan which includes orthodontic coverage.
    • Vision: Employee vision care coverage is available through Vision Service Plan (VSP).
  • Retirement – Employer-matched CalPERS Pension and 401(a) plans, 457 Plan.
  • Time off – 23 days of Paid Time Off (PTO) and 13 paid holidays.
  • Professional development: Opportunities for tuition reimbursement, professional license/membership.

ABOUT SFHP:

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-income residents in San Francisco County. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 175,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services.

San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

San Francisco Health Plan is an E-Verify participating employer.

Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.

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