You can improve the wellbeing of San Francisco's most vulnerable population.

Reporting to the Health Services Officer, the Manager, Behavioral Health manages the administrative aspects of all delegated and carved out behavioral health and substance use disorder programs for San Francisco Health Plan (SFHP).

Delegated Behavioral Health Programs:

• Non-specialty mental health and Behavioral Health Treatment (BHT) services for Medi-Cal, which are currently delegated to a Managed Behavioral Health Organization (MBHO).
• Behavioral health services for the plan’s commercial product line, Healthy Workers, currently provided by the San Francisco Department of Public Health Behavioral Health Services (BHS).

Carved Out Programs:

• Specialty Mental Health Services (SMHS) and Drug Medi-Cal (DMC) are “carved out” from SFHP’s Medi-Cal contract. Coordination and collaboration with County BHS, Drug Medi-Cal Organized Delivery System (DMC-ODS) and private substance use providers is essential in the success of SFHP’s care coordination and delivery of service.

You will be the primary clinical liaison to both vendors and internal departments. You will provide oversight and maintain relationships with vendor services.

Salary Range: $112,742 to $140,928

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.

WHAT YOU WILL DO

• Responsible for managing the MBHO contract and overall relationship:
  • Develop contract goals.
  • Monitor performance against goals and ensures successful completion.
  • Ensure delegated quality, utilization management and credentialing. performance meets aforementioned requirements.
  • Collaborate effectively with the MBHO management team.
• In coordination with Delegation Oversight staff, perform annual oversight audit of MBHO and delegated providers and review delegates’ corrective action plans.
• Collaborate with MBHO, SFHP delegated medical groups (DMGs), and SFHP Provider Network Operations to ensure effective, accessible behavioral health programs are in place and to problem-solve with key network partners as necessary.
• Ensure compliance with all regulatory and contract requirements for mental health and substance use treatment services in accordance with DHCS and DMHC.
• Develop and maintain behavioral health and substance use disorder treatment policies and procedures as needed.
• Manages staff. Maximize staff performance on efficiency and productivity. Train, coach, motivate, and update staff.
• Collaborate with SFHP Grievance Review team on reviewing and adjudicating behavioral health complaints and grievances; participate in SFHP Grievance Review Committee discussions of MBHO grievances; serve as a subject matter expert on grievances with behavioral health components.
• Establish relationships and engages with BH providers to improve clinical and quality outcomes for members.
• Create and maintain linkages between providers of all levels of care, as well as other community-based services and resources to improve transitions of care and continuity of services.
• Partner with network providers, MBHO, and other stakeholders to operationalize innovative programs and strategies to improve clinical and quality outcomes and behavioral health HEDIS measures performance.

WHAT YOU WILL BRING

• Minimum Requirements: MA/MS or above in Behavioral Health field and minimum of 7 years of professional experience in healthcare which includes a minimum of 3 years of experience in Medi-Cal managed care; and a combination of education and experience, which would provide an equivalent background.
• Current, valid, independent, and unrestricted license such as RN, LCSW, LMFT, LMHC, LPC, or Licensed Psychologist (as allowed by applicable by California is required)
• Five years progressive management experience.
• NCQA standards knowledge preferred.
• Experience with the audit process of clinical activities preferred.
• Experience working in quality management/improvement, preferred.

WHAT WE OFFER:

• A competitive and robust compensation package, including:
• Health benefits
  • Medical: You’ll have a choice of medical plans, including options from Kaiser and Blue Shield of California. Employee-only coverage in the HMO plans is currently available at no cost and dependent coverage is 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.
• An opportunity to work in a vibrant atmosphere with the most amazingly talented people who are shaping the future of healthcare!
• The chance to make a difference in the lives of many San Francisco residents!

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. 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.

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.