Talent.com
Manager, Medicare Programs
Manager, Medicare ProgramsSan Francisco Health Plan • San Francisco, CA, United States
Manager, Medicare Programs

Manager, Medicare Programs

San Francisco Health Plan • San Francisco, CA, United States
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

You will report to the Sr. Director, Product and Growth and manages the SFHP Care Plus (a Medicare Dual Special Needs Plan) product development lifecycle, working to gather team member input and deliverables within required timelines. You will ensure the annual Plan Benefit Package (PBP) and bid submissions comply with regulatory requirements and deadlines. Additionally, the Manager, Medicare Programs will support activities to monitor ongoing compliance and high-quality operational performance of staff and the program.

You will be a subject matter expert, support functional teams with annual implementation, readiness for Annual Enrollment Period and product go-live for each plan year. The Manager, Medicare Programs will focus on process improvement, organizational change management, program management and other processes relative to Product and organizational priorities. Also, you will lead building business programs, in collaboration with operational leaders, to meet critical compliance and operational needs.

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 : $113,000 - $133,000 per year

WHAT YOU WILL DO :

  • Bring Medicare experience, support SFHP's D-SNP operating model, and lead planning and implementation efforts.
  • Support functional decision-making in building a Medicare program by sharing expertise of industry best practices and facilitating tactical workstreams.
  • Manage the annual Medicare / D-SNP plan benefit package design and applications process.
  • Manage and apply product development lifecycle to the application process, bid development, benefit designs, member materials, and go-to-market strategy.
  • Support team members in the identification and planning of short- and long-term strategies to help develop our D-SNP product.
  • Be an internal subject matter expert (SME) and ensure readiness of D-SNP operational functions and performance (e.g., Marketing, Sales, Enrollment, Risk Adjustment, STARs).
  • In collaboration with our Enterprise Project Management Office, help develop project plans, operational and performance readiness plans, and timelines to support a successful D-SNP product.
  • Engage and oversee the work of external vendors.
  • Support network adequacy reporting and documentation with Provider Services and other departments to ensure that plan meets all network adequacy standards for the application and on an ongoing basis.
  • Collaborate with Member Services to develop and implement an operational strategy for D-SNP Customer Services and Grievances and Appeals functions.
  • Develop internal communication documents and Medicare training criteria for SFHP employees and first tier downstream entities.
  • Develop documentation to support meeting presentations and the tracking and reporting of the program's performance.
  • Support Medicare program development with requirements gathering, business case creation, and improvement plans.
  • Contribute to and / or lead detailed data analysis.
  • Support functional teams through information exchange, training, and collaboration

WHAT YOU WILL BRING :

  • Bachelor's degree in public health, administration, business, or other related areas; or equivalent work experience. Masters degree preferred.
  • 5 or more years' experience in product development, process improvement or product management, within a Medicare environment.
  • 3 or more years of leadership / people management experience.
  • 2 or more years' experience developing operational Medicare components.
  • Knowledge of state and federal managed care program requirements, including Medi-Cal and Medicare health care laws.
  • 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.

    #LI-Hybrid

    (Hybrid remote / in-office)

    Please see job description

    PI278878196

    Job distributed by JobTarget .

    serp_jobs.job_alerts.create_a_job

    Program Manager • San Francisco, CA, United States

    Job_description.internal_linking.related_jobs
    Program Manager

    Program Manager

    By the Bay Health • Larkspur, CA, US
    serp_jobs.job_card.full_time
    By The Bay Health, a non-profit established in 1975, set the standard for hospice in the U.Our spectrum of home-based services now includes Skilled Home Health Care, Palliative Care, Adult Hospice ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Field Reimbursement Manager, Oncology (San Francisco)

    Field Reimbursement Manager, Oncology (San Francisco)

    J&J Family of Companies • San Francisco, CA, US
    serp_jobs.job_card.permanent
    Johnson & Johnson Innovative Medicine's Patient Engagement and Customer Solutions (PECS) team is recruiting for a Field Reimbursement Manager which will be a field-based position in the San Francis...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Field Reimbursement Manager Tzield California (CA, NV)

    Field Reimbursement Manager Tzield California (CA, NV)

    Sanofi • San Francisco, CA, US
    serp_jobs.job_card.full_time
    Field Reimbursement Manager Tzield California (CA, NV).At Sanofi, we are dedicated to transforming patient health through chasing the miracle of science. As a prominent pharmaceutical manufacturer,...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Senior Clinical Program Manager

    Senior Clinical Program Manager

    Revolution Medicines • Redwood City, CA, US
    serp_jobs.job_card.full_time
    Senior Clinical Program Manager.Revolution Medicines is a clinical-stage precision oncology company focused on developing novel targeted therapies to inhibit frontier targets in RAS-addicted cancer...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Program Manager V - National Health Plan Enablement & Integration

    Program Manager V - National Health Plan Enablement & Integration

    Kaiser Permanente • Oakland, CA, US
    serp_jobs.job_card.full_time
    Program Manager V - National Health Plan Enablement & Integration.The new National Health Plan Enablement & Integration teams objective is to deliver immediate outcomes for the organization, while ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Acute Inpatient Care Coordination Manager

    Travel Acute Inpatient Care Coordination Manager

    Ardor Health Solutions • Greenbrae, CA, US
    serp_jobs.job_card.full_time
    Ardor Health Solutions is seeking a travel nurse RN Case Management for a travel nursing job in Greenbrae, California.Job Description & Requirements. Ardor Health Solutions is looking for a Case...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    R&D Manager

    R&D Manager

    U-Haul • San Francisco, CA, US
    serp_jobs.job_card.full_time
    Are you looking for more responsibility while taking the next step in your career? Are you a person who loves to help others? Then consider becoming U-Haul Company's newest R&D Manager! As R&D mana...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Senior Program Manager

    Senior Program Manager

    Probably Genetic • San Francisco, CA, US
    serp_jobs.job_card.full_time
    Probably Genetic is changing the lives of patients living with severe, complex diseases.Our data platform is used by drug developers and patient advocacy groups to develop and launch treatments for...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Regulatory Program Manager - Health

    Regulatory Program Manager - Health

    Apple • San Francisco, CA, US
    serp_jobs.job_card.full_time
    Regulatory Program Manager - Health.San Francisco Bay Area, California, United States.Our ever-evolving suite of health and wellness products are helping our users live more active, healthier lives...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Clinical Program Manager

    Clinical Program Manager

    Revolution Medicines • Redwood City, CA, US
    serp_jobs.job_card.full_time
    Revolution Medicines is a clinical-stage precision oncology company focused on developing novel targeted therapies to inhibit frontier targets in RAS-addicted cancers. The company's R&D pipeline com...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Acute Inpatient Care Coordination Manager

    Travel Acute Inpatient Care Coordination Manager

    American Traveler • Greenbrae, CA, US
    serp_jobs.job_card.full_time
    American Traveler is seeking a travel nurse RN Case Management for a travel nursing job in Greenbrae, California.Job Description & Requirements. American Traveler has an opening for a Travel RN ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    Health Care Program Director (Full Specialist) - UC Berkeley Labor Center

    Health Care Program Director (Full Specialist) - UC Berkeley Labor Center

    InsideHigherEd • Berkeley, California, United States
    serp_jobs.job_card.full_time
    Health Care Program Director (Full Specialist) - UC Berkeley Labor Center.The UC academic salary scales set the minimum pay determined by rank and step at appointment. See the following table(s) for...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Manufacturing Program Manager (Medical Devices)

    Manufacturing Program Manager (Medical Devices)

    Ampa Inc. • San Francisco, CA, United States
    serp_jobs.job_card.permanent
    Manufacturing Program Manager (Medical Devices).Ampa is a pioneering neurotechnology startup developing brain stimulation technology to. We will improve millions of lives by making this transformati...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Revenue Integrity Program Manager (Remote)

    Revenue Integrity Program Manager (Remote)

    Stanford Health Care • Stanford, CA, US
    serp_jobs.filters.remote
    serp_jobs.job_card.full_time
    Revenue Integrity Program Manager.The Revenue Integrity Program Manager is a critical role responsible for optimizing hospital and professional revenue, identifying potential revenue leakage while ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Field Reimbursement Manager, Pulmonology and Gastroenterology, San Francisco

    Field Reimbursement Manager, Pulmonology and Gastroenterology, San Francisco

    Sanofi • San Francisco, CA, US
    serp_jobs.job_card.full_time
    Field Reimbursement Manager, Pulmonology And Gastroenterology, San Francisco.In this field-based position, the FRM will report to the assigned FRM Director. About the job : We are an innovative globa...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Program Director / Healthcare Operations Manager

    Program Director / Healthcare Operations Manager

    Healogics • Burlingame, CA, United States
    serp_jobs.job_card.full_time
    The rewards at Healogics are immense, starting with the important work we do to change patients’ lives.We also understand that meaningful work is hard work, and we are committed to supporting and c...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Field Reimbursement Manager

    Field Reimbursement Manager

    Syneos Health • San Francisco, CA, United States
    serp_jobs.job_card.full_time
    San Francisco, CA, United States.You are an expert facilitator : you open doors, foster communication, and bridge the gap. In this role, you will operate as the subject-matter expert on reimbursement...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Clinical Manager

    Clinical Manager

    Bass Surgery Center (11621) • WALNUT CREEK, California, United States
    serp_jobs.job_card.full_time
    Bass Surgery Center is hiring a Clinical Manager.Welcome to Bass Surgery Center,.ASC environment committed to producing the highest quality work and experience for patients and their families.Clini...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel Acute Inpatient Care Coordination Manager

    Travel Acute Inpatient Care Coordination Manager

    Synergy Medical Staffing • Greenbrae, CA, US
    serp_jobs.job_card.permanent
    Synergy Medical Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Greenbrae, California.Job Description & Requirements. Location : Greenbrae, California.Shift : 5x8...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    ECM Lead Care Manager

    ECM Lead Care Manager

    MASC Medical Recruitment Firm • Oakland, CA, United States
    serp_jobs.job_card.full_time
    This position is full-time and remote.Must be available for in-person interactions as needed).Patient Care Manager who lives in. The focus of assistance is in enhancing the quality of patient manage...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted