Established in 1997, San Francisco Health Plan (SFHP) is a 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. San Francisco Health Plan is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 145,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves, and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.
- The Healthy Kids Program Manager oversees the administration of the Healthy Kids program, a subsidized health insurance program sponsored by the Department of Public Health (SFDPH) for children ages 0 – 19 residing in San Francisco. This position manages a wide range of day-to-day operations and administrative support for the program at the San Francisco Health Plan (SFHP), which serves as the Third Party Administrator (TPA) for Healthy Kids.
- The Healthy Kids Program Manager will lead and shape program activities to ensure program goals, initiatives and changes are completed in a high quality, timely, and efficient manner. The manager will collaborate with cross-functional SFHP teams and external community partners, particularly the SFDPH and California Department of Health Care Services to effectively meet the needs of approximately 1,000 HK members.
- The candidate for this position must be highly organized with proven success managing a diverse set of administrative and programmatic functions. They must possess strong verbal and written communication skills, proven ability to initiate and deliver program improvements, possess good judgment, an ability to work independently, and exercise close attention to detail to ensure operational processes are executed in alignment with program policies, rules and guidelines.
- The Program Manager must show flexibility and responsiveness to an environment with frequent program changes and new requirements. In addition, they must have a strong commitment to the mission of universal health coverage for children in San Francisco.
WHAT YOU'LL DO
- Develop, manage and monitor operational processes supporting the Healthy Kids program. This includes eligibility management, communications, utilization of services, financing and reporting.
- Manage key stakeholder relationships, including the SF Department of Public Health, CA Department of Health Care Services, SF Human Services Agency and other community organizations supporting health coverage for children.
- Lead and manage Healthy Kids projects including systems enhancements, procedural clarification and updates, and policy changes.
- Manage reports to the SF Department of Public Health and Department of Health Care Services on Healthy Kids activities and outcomes. Coordinate and manage the collection of content from internal department sources, validate content accuracy, format and revise content, and deliver completed reports in a timely and accurate manner.
- Create and maintain documentation for the Healthy Kids Program, including desktop procedures, process flows, user guides, data definitions, and business rule documents.
- Train program support staff performing administrative functions to support Healthy Kids, including customer service, marketing, IT, enrollment and eligibility.
- Research and resolve Health Kids eligibility issues, and respond to applicant, member or provider inquiries by phone and email. Coordinate resolution of operational issues with external partners and/or other SFHP departments as needed.
- Lead Healthy Kids strategic planning, including development of annual project or initiative roadmaps, and annual budget planning and preparation.
WHAT YOU'LL BRING
- Bachelor’s degree in Public Health, Health Services or related field
- Master’s degree in public policy, public administration or health related field preferred.
- Equivalent professional experience in program management, project management, or health plan administration acceptable.
- 2-3 years of relevant experience in public health program highly desirable
- Experience in policy and procedures development or write –ups highly preferred
- Strong analytical and critical thinking skills. Effective problem-solver with superior organizational, time-management and multi-tasking skills.
- Attention to detail and willingness to assist at all levels in order to ensure on time and accurate deliverables. Proven ability to consistently produce high quality, reliable work products
- Ability to identify, reconcile and identify differences between reports and data sources.
- High level of professionalism communicating through verbal and written forms.
- Knowledge of local and state health care programs including Covered California, Medi-Cal, the Health Care Security Ordinance and Healthy San Francisco is preferred.
- Understanding of the basic provisions of the Affordable Care Act and its implementation in California is preferred.
- High proficiency in MS Office (Word, Excel, PowerPoint, Access, Outlook). Competency in Microsoft Visio and SharePoint preferred.
- Prior experience in creating actionable management level reporting to support organizational initiatives.
- Prior project management and leadership experience in cross-functional projects, including prioritizing tasks and adhering to schedules to meet project deadlines and deliverables.
San Francisco Health Plan is an Equal Opportunity Employer (EOE) M/F/D/V
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.