San Francisco Health Plan

  • Manager, Coverage Programs Finance

    Job Locations US-CA-San Francisco
    Job ID
    Policy Development & Coverage Programs
    Regular Full-Time
  • Overview


    Are you ready to make a difference in the San Francisco community? Take your leadership skills in finance to the San Francisco Health Plan.


    SFHP is currently looking for a Coverage Programs Finance Manager to lead the establishment of a rapidly growing financial unit supporting three coverage programs at the San Francisco Health Plan (SFHP). SFHP is the third-party administrator for Healthy San Francisco, the SF City Option Program and Healthy Kids on behalf of the San Francisco Department of Public Health (SFDPH). The team is responsible for the financial operations, planning, budgeting and forecasting for all three programs.


    The Coverage Programs Finance team is currently centered on member/participant billing and payment processing for employers participating in the SF City Option program. The Manager, under the guidance of the Director, Policy Development & Coverage Programs, will thoughtfully and strategically identify emerging and urgent issues within the programs and grow their team to support those functions. These may include new auditing, reporting and/or analytic functions.


    The ideal candidate for the position will be well-versed in regulatory requirements and procedural best practices, with proven experience in an operational billing services role. The candidate will bring a sophisticated and comprehensive approach to problem-solving and possess superb verbal and written communication skills to effectively recommend, update and inform senior management.

    The Manager will thrive in a fast-paced and evolving environment where program rules frequently change and require the development of new processes or systems. They will exhibit flexibility and responsiveness, and possess strong leadership and management ensuring a high-performing team.



    • Direction and guidance: provide leadership on necessary and required oversight of financial operations supporting the coverage programs.
    • Build team: recruit and hire talented staff to perform team functions with superior quality, accuracy and dependability.
    • Team efficiency: provide thoughtful recommendations to resolve gaps or implement improvements to mitigate financial risk, reduce manual effort, or increase efficiency.
    • Projections and forecasting: provide projections and forecasting for the coverage programs. Contribute to annual budget planning and advises the team, department and the SF DPH on ensuring the financial health and viability of the programs.
    • Financial operations: oversee and ensure all financial transactions pertaining to HSF, SF City Option, and Healthy Kids are accurately processed. Includes oversight of over 150,000 reimbursement accounts and 1,500 employers making payments to the SF City Option, 13,000 participants in Healthy San Francisco, and 2,000 Healthy Kids members.
    • Audits: establish routine audit processes of SFHP internal financial responsibilities as well as external vendor contractual requirements.
    • Operational excellence: ensure ongoing operational efficiency, effectiveness and customer service standards of the Coverage Programs Finance Oversee and monitor the day-to-day productivity, workflow, distribution and prioritization of work assignments for the Coverage Programs Finance team, as well as all training and quality improvement efforts.
    • Policies, procedures, and processes: create and develop policies, procedures, and business processes as needed for finance-related HK, HSF or SF City Option program management. Ensure all policies, procedures, business process flows, operating guides are maintained and updated regularly.
    • Collaboration: Partner with other department Managers and cross-functional teams within the organization on:
      • Oversight, development, testing and roll out of system enhancements for the applications supporting financial processes. Act as the Administrator and subject matter expert for SFHP’s proprietary Premium Billing System (PBS), the application used to process Healthy San Francisco participant billing.
      • Providing the highest level of service at all levels, including client and vendor management for the coverage programs. Ensure high quality service to the San Francisco Department of Public Health, members, participants, employers and providers.
      • Establishing, implementing and utilizing meaningful, measureable metrics, strategies and incentives that will drive high performance and outstanding customer service.


    • Bachelor’s degree in finance, business administration or other health administration field required; or equivalent work experience. Master’s degree preferred.
    • At least two years of experience in health plan administration, managed care, billing or reimbursement services.
    • At least two years managing direct reports with demonstrated success supervising a high-performing team.
    • Proven ability to prioritize, multi-task and operate successfully under limited supervision.
    • Strong computer skills (MS Outlook, Word, Excel, PowerPoint).
    • Prior experience with Great Plains, QNXT, or One-e-App is highly desired.
    • Demonstrated knowledge of managed care or health reimbursement accounts, including eligibility, premium billing and claims reimbursement preferred.
    • Understanding of San Francisco coverage programs, the Health Care Security Ordinance (HCSO), Medi-Cal and Covered CA preferred.
    • Strong analytic and critical thinking skills. Effective problem-solver with superior organizational, time-management and multi-tasking skills. Proven ability to consistently produce high quality, reliable work products.



    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 (SFHP) is the public Medi-Cal managed care plan for San Francisco serving 135,000 Medi-Cal members. SFHP also acts as a Third-Party Administrator to support the SF Department of Public Health for Healthy Kids, Healthy San Francisco and the SF City Option.


    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.


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