Reporting to the Chief Executive Officer (CEO) and serving as a member of the Executive Team, the Chief Operating Officer (COO) leads all primary service operations for San Francisco Health Plan (SFHP). You will translate SFHP's strategic plans into operational priorities and measurable results, ensuring that member- and provider-facing operations are efficient, compliant, and focused on service excellence. You will partner with peer executives to strengthen organizational processes and infrastructure so SFHP can continue to grow and fulfill our mission.
You will be accountable for teams in Business Solutions, Customer Service, Claims, Grievances and Appeals, Member Eligibility Management, Provider Contracting, and Provider Relations.
This is a hybrid position, based in our Downtown San Francisco office. Please note that while SFHP supports a hybrid work environment, SFHP requires you to work onsite and in-office a minimum of 4 days per month. We expect the minimum onsite requirement to increase to 8 days per month, beginning in early 2027.
This position requires the you to reside within the State of California and be able to report to our Downtown San Francisco office as required.
Salary: $350,000 to $400,000
WHAT YOU WILL DO:
- Be a member of the Executive Team, partnering with the CEO and peer executives to develop and achieve SFHP's strategic plan and organizational goals.
- Lead and retain a high-performing leadership team, promoting a culture of accountability, collaboration, and learning. Oversee organizational design, workforce planning, and succession planning for Operations.
- Translate organizational strategy into a multi-year operational plan, and lead execution through measurable results.
- Lead enterprise-wide initiatives that improve efficiency, scalability, and the member and provider experience, including support for CalAIM programs.
- Assess the operational impact of legislative, regulatory, and Medi-Cal and Medicare policy changes, and lead our operational response.
- Advise the CEO and Executive Team on operational risks, opportunities, and resource needs.
- Provide executive oversight of all departments in Operations.
- Establish, monitor, and report on operational performance goals, KPIs, and service-level metrics aligned with SFHP's strategic goals.
- Partner with Finance on financial planning, cost management, and investment decisions related to staffing, resources, and vendors.
- Present operational updates, performance results, and recommendations to the Governing Board and its committees.
- Represent SFHP with regulators, provider partners, the City and County of San Francisco, community organizations, and other external partners.
- This job description outlines the primary responsibilities of the role and it's not an exhaustive list.
WHAT YOU WILL BRING:
- Bachelor's degree in a related field required; master's degree in business administration, health care administration, public health, public administration, or a related field preferred.
- 15+ years of progressive leadership experience, including at least 5 years in a leadership position overseeing large, multi-department operations.
- Experience in a managed care organization or health plan such as Medi-Cal and Medicare lines of business.
- Demonstrated experience in budget development, financial planning and analysis, and resource management.
- Expertise developing and monitoring systems to manage complex and collaborative operational work.
- Knowledge of the California health care landscape, including government-sponsored programs, and of DHCS, DMHC, and CMS requirements.
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)