Chief Operating Officer

Reporting to the Chief Executive Officer (CEO) and as a peer to the other executives, the Chief Operating Officer (COO) leads critical health plan operations and contributes to strategic planning for the organization. You will function as a key leader within the health plan and have the authority to enhance the internal organizational processes and infrastructure that will allow San Francisco Health Plan (SFHP) to continue to grow and fulfill its mission. You will proactively collaborate with the CEO in implementing the organization’s strategic goals, partnering and regularly interfacing with peer executives and other leaders. You will have accountability for the following functions: Business Solutions, Customer Service, Claims, Coverage Programs, Enterprise Project Management Office, Facilities Management, Information Systems, Marketing & Communications, Medicare Product, Member Eligibility Management, Provider Contracting, and Provider Relations.

Please note - this position will require an in-office, on-site presence 4-8 times per month or as business needs require.

WHAT YOU WILL DO

• Strategic planning and oversight of all departments in Operations to ensure health plan operations are running smoothly.
• Responsible for the accurate and timely provision of information and documentation within the Customer Service, Member Eligibility Management, Claims and Provider Network Operations Departments at SFHP. These departments are the key points of contact for members and providers and serves as the primary intake for eligibility and areas of interchange between the Plan and its partners.
• Accountable for maintaining provider agreements and ensuring internal compliance with those agreements.
• Responsible for maintaining functional relationships with provider partners.
• Direct responsibility for the strategic implementation and execution of SFHP’s information systems, application development, telecommunication and technical support services, ensuring the overall safety and security of member and provider ePHi in accordance with HIPAA guidelines.
• Accountable for appropriate deployment of Business Solutions resources to drive uptake and use of automated solutions and continuous improvement tools to streamline health plan operations.
• Ensure timely and effective communication with members and providers, while meeting DHCS’ and DMHC’s regulatory and contractual requirements.
• Accountable for mitigating risk to SFHP in administrative (non-provider) agreements.
• Champions excellent customer service and consistently motivates staff to deliver outstanding service to both internal and external customers.
• Identify, implement, monitor, measure and report on the appropriate performance goals and metrics aligned with and supportive of SFHP strategic goals and objectives.

Leadership Expectations

• Partner proactively and effectively with members of the management teams. Provide information, insight, and leadership to ensure ongoing improvement and efficiencies of SFHP business processes and development of financially sound and mission-aligned business strategies, goals, and metrics.
• Interact actively with SFHP leaders, management, and staff in professional, collegial, and appropriate manner always. Treat all confidential information with discretion and care. Always maintain a professional demeanor.
• Use sound business judgment. Resolve basic to complex issues appropriately and effectively. Well organized. Analyses, plans and recommendations are well reasoned, timely, thorough, and accurate and enhance the organization’s financial decision-making capacity. Produce high quality, reliable work product consistently.
• Assess criticality of issues/problems quickly and correctly. Identify actual and potential fiscal and operational impact. Recommend and/or implement appropriate and/or best practice solution sets. Strive for proactive, preventative actions rather than reactive actions.
• Work effectively and efficiently as a team leader and as a team player. Work individually effectively and efficiently with minimal supervision in a diverse, dynamic, deadline driven environment.
• Hire, develop, mentor, manage and train diverse departmental staff to build and retain a highly qualified, high performing team. Ensure departmental and SFHP performance competencies and metrics are appropriately defined, communicated, implemented, measured, and understood by all team members.
• Understands and recognizes the value of a diverse workforce and partners with HR and the DEI committee to ensure diversity at all levels of the organization including staff, leadership, vendors, and contractors we engage with. Participates in DEIB events and supports staff involvement in DEIB activities and committees.
• Balance talent and fiscal resources and constraints to optimize IT investments in partnership with the Information Officer.
• Provide ongoing, timely, constructive performance feedback to members of his/her team that fosters individual and team high performance, work-related efficiencies and effectiveness, core and advanced skill development and value-added contribution. Ensure appropriate actions are taken and attendance, conduct and/or performance problems are effectively and timely addressed and resolved. Take appropriate actions to ensure openness and fairness in all stages of the corrective and disciplinary action process.
• Partner with Human Resources to ensure the highest level of employee engagement and a positive work culture for staff. Notify Human Resources timely to ensure all team members are counseled timely and appropriately and provided with all necessary information and documentation about SFHP health and welfare and time off policies and benefits, including but not limited to, leaves of absence, disability, unemployment, and COBRA.

WHAT YOU WILL BRING

• Bachelors degree; an advanced degree (MBA, CPA, MPA, MPH) preferred.
• Strong operational experience with 10+ years experience in a senior management role for a socially responsible organization with progressive experience leading to at least 5 years’ experience in operational/administrative management.
• Demonstrated excellence with organizational development, staff management, budget and resource development, and strategic planning; demonstrated success developing and monitoring systems to manage both operational and programmatic work that involve high levels of collaboration.
• Demonstrated experience in financial planning and analysis.
• Strong collaboration, communication and influence abilities.
• Demonstrated experience uniting and leading large groups or teams across an enterprise.
• Excellent people skills, with an ability to partner with a dynamic leadership team.
• Knowledge of California health care structure, especially government-subsidized care.

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!

Salary Range: $340,000 - $380,000

San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports and respects all individuals and in which our 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.