Reporting to the Senior Manager, Concurrent Review & Long Term Care, the Long-Term Care Nurse Manager oversees daily operations, programmatic and regulatory requirements for Long-Term Care, Post-Acute Care and Complex Discharge processes at SFHP. Together with Clinical Operations Leadership, you will establish operational goals for these teams and delegate to staff. You will interact cross-functionally and with varying leadership levels to collaborate on internal projects and external relationships.

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 range: $145,000 - $165,000

WHAT YOU WILL DO:

• Manage Long-Term Care (LTC), Post-Acute Care (PAC) and Complex Discharge (CDC) teams of hybrid staff to include clinical and non-clinical positions.
• Serve as primary escalation contact to acute care hospitals and post-acute facilities to ensure staff is receiving prioritized placement to the appropriate level of care and complex discharge assistance.
• Ensure NCQA, DHCS, and DMHC regulatory requirements are met and SFHP policy standards are upheld.
• Follow PAC and LTC regulatory requirements, measurements (KPI's) and productivity metrics, providing analysis and action plans for applicable elements.
• Assume oversight of internal and external audit processes to ensure all regulatory requirements are met and participate in creating corrective action plans or remediation.
• Work with Long-term Acute Care hospitals (LTACs), skilled nursing facilities (SNF), sub-acute (SA) and intermediate care facilities (ICF) to ensure SFHP members are receiving appropriate and quality care in post-acute settings.
• Develop relationships with hospitals and community partners to ensure safe, high-quality, cost-effective transitions processes for our members.
• Foster an environment that solicits and enlists diverse and inclusive perspectives and approaches to better serve our staff, our members and our providers.

WHAT YOU WILL BRING:

• Valid unrestricted Registered Nurse license in the state of California.
• A current CA RN license to practice without restriction.
• Managed care experience in utilization review, resource management.
• Two to five years' experience in an acute care or post-acute setting.
• Two to three years of people management experience.
• Experience working with socially and ethnically diverse populations.
• Experience with Medi-Cal and Department of Healthcare Service regulations and standards.

WHAT WE OFFER:

• Health benefits
  • Medical: You'll have a choice of medical plans, including options from Kaiser and Blue Shield of California. 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.

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

PI256008251