Reporting to the COO, the Senior Director of Medicare Product and Growth provides strategic leadership and oversight of Medicare product and growth programs and activities for SFHP. You will have P&L accountability for SFHP’s Medicare product, lead the annual bid planning cycle, own and direct a variety of committees to support product objectives, serve as liaison between the product team and external partners, and ensure overall CMS, DMHC and DHCS compliance for SFHP’s D-SNP product. You will manage a diverse, qualified staff and ensure they meet their goals.

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

Salary: $205,000 to $245,000 per year

WHAT YOU WILL DO:

• Develop and implement SFHP's product and growth strategies, aligning with organizational goals and regulatory requirements.
• Oversee Medicare D-SNP growth strategies.
• Manage a team and provide them with development and guidelines to succeed.
• Lead programs aimed at improving member satisfaction and retention, increasing health literacy, and enhancing provider relationships.
• Design programs and tools to improve member communication, education, and access to care.
• Use data analytics to identify and address gaps in member engagement and ensure equitable access to services.
• Build relationships with community-based organizations, advocacy groups, and public health entities.
• Represent SFHP at community events and forums to promote awareness and partnerships.
• Create and lead venues (e.g. Advisory Boards, focus groups) to capture member and provider voice of customer feedback. Develop action plans to improve member and provider experience and retention. Lead efforts to address findings from audits or compliance reviews.
• Ensure all engagement programs comply with Medi-Cal guidelines and reporting requirements.
• Ensure departmental and SFHP performance competencies and metrics are defined, measured, and understood by all team members.
• Present regular updates on growth metrics, outcomes, and strategic priorities.
• Ensure that benefits comply with CMS and DHCS mandates and meet partner needs.
• Develop competitive positioning analysis and present reports to Senior Leadership for approval.
• Responsible for P&L accountability for SFHP products. Develop KPIs for product performance. Monitor product performance and work functionally to drive performance improvement.
• Serve as a liaison between the product team and provider partners, ensuring that all parties are aligned with the product's vision and objectives. Work with provider partners on co-marketing, benefit input/feedback, community engagement activities.
• Ensure ROI for supplemental benefits and exceptional vendor performance. Ensure rates for services and exceptional member experience.
• Define target market and overall product strategy for SFHP.
• Lead product, bid development, and application efforts and collaborates with cross functional teams and consultants.
• Approve product strategy and bids for upcoming benefit year to ensure alignment with organizational growth and profitability objectives. Develop and present SFHP product strategy to Leadership for approval.
• Oversee training. Lead training sessions.
• Communicate with the product team and external partners such as LHPC, DHCS and CMS meetings/communications.

WHAT YOU WILL BRING:

• Bachelor’s degree in Business, Public Health, Public Policy/Administration, or in a related field or equivalent work experience; an advanced degree (MBA, MHA/MHSA, MPH) preferred.
• 10+ years of experience in healthcare, with a focus on managed care or Medi-Cal programs and managing, developing, and foster innovation.
• 7+ years of experience in a leadership role with at least 5 years of experience in an operations or administrative capacity.

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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