Medical Director

San Francisco Health Plan is committed to providing high-quality care for low-income San Franciscans and supporting the provider safety net. We leverage our resources to support the triple aim : improved population health, improved quality of care, and improved affordability. The individual in this position is the Plan's primary UM physician conducting concurrent and prior authorization case reviews, is the health plan physician lead on the Health Homes program and the San Francisco Safety Net Pain workgroup, and provides physician consultative expertise to the health services department : clinical operations (UM : inpatient and outpatient, and discharge transition planning), health improvement (HEDIS, practice improvement, disease management, member grievance reviews, IT systems that support department functions, and member incentives) and pharmacy (including PGY 1 pharmacy residency and medication therapy management program). The Medical Director also plays an important role with key health plan initiatives, such as the implementation of a care management system designed to improve coordination of care and achieve better clinical outcomes, creating clinical criteria, and evaluating UM strategies to improve efficiency.

Salary range : $241,950 - $288,750

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.

WHAT YOU WILL DO

Leadership

• Provides primary leadership of SFHP's program which serves at risk and medically complex members as defined by internal risk stratification as well as health plan mandate (e.g. Health Homes)..
• Provides SFHP clinical leadership of the San Francisco Safety Net Pain Management workgroup.

Clinical Decision Making and Support Utilization Management

Quality

Provides clinical input for programs :

Pharmacy

Utilization Management

Clinical Quality

WHAT YOU WILL BRING

WHAT WE OFFER

Health Benefits

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

PI278849745

Job distributed by JobTarget .