Chief Executive Officer

Position Description

Company: Health Plan of San Mateo
Position: Chief Executive Officer
Reports to: San Mateo Health Commission
Dept: Executive
FLSA Status: Exempt
Location: South San Francisco, CA

General Description

Provide leadership to further the Health Plan of San Mateo’s mission and vision and the achievement of the Triple Aim: improving the HPSM member experience; improving the health of HPSM populations; and reducing the per capita cost of health care. Lead the development and direct the successful implementation of short-term and long-term strategic goals and plans for HPSM; direct and oversee HPSM programs and functional areas through the leadership team; work collaboratively with the San Mateo Health Commission, HPSM’s governing body, San Mateo County Health, other key County departments, and community based organizations; develop and maintain positive working relationships with HPSM providers, members, community representatives, and federal, state, and county agencies on behalf of HPSM; lead development of health policy affecting underserved residents of San Mateo County; attract and retain the talent necessary for HPSM to be a highly effective organization.

Duties & Responsibilities

Formulate and implement short-term and long-term strategic goals and plans for the organization in accordance with HPSM’s mission and under the direction of the San Mateo Health Commission.
Lead planning and development of HPSM programs and services, especially integrated services in the areas of long-term services and supports, behavioral health and substance use disorder services, dental integration, and Medicare/Medicaid benefit and service integration.
Lead internal administrative, operational, and financial operations through the leadership team.
Working through clinical and other HPSM leaders, ensure continuous quality improvement in organizational performance, member health outcomes, member access to care, health cost trends, and member and provider satisfaction and experience.
Working through technology, data analytics, and other HPSM leadership, ensure HPSM uses and shares data effectively to promote improvements in members outcomes and provider collaboration and effectiveness.
Working through the Chief Compliance Officer, ensure organization operates according to the highest ethical standards and maintains compliance with federal and state regulations.
Work closely with the San Mateo Health Commission and its advisory committees to support the oversight and policy making functions of the Commission.
Work collaboratively with a wide variety of external individuals and organizations to ensure effective and efficient HPSM operations, and in the development of goals and policies in accordance with HPSM’s mission. These organizations and individuals include but are not limited to:
Providers, members, and community agencies covering a broad range of medical, behavioral health, substance use disorder, housing, and social services;
San Mateo County Health and other key County agencies such as Human Services and Housing;
State regulatory and payer agencies such as the Department of Health Care Services, the Department of Managed Health Care, the Department of Public Health, California Department of Aging, the Department of Social Services, and the Department of Developmental Services;
Federal regulatory and payer agencies such as the Center for Medicare and Medicaid Services and the Health and Human Services Agency and private accreditation agencies such as the National Committee for Quality Assurance; and
Local, State, and Federal elected officials and their staff.
Select and retain HPSM talent to maintain staff with breadth and depth sufficient to attain and surpass HPSM goals and objectives. Provide direction to leadership team, department directors, and other key personnel.
Accomplish staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and implementing corrective action steps when necessary; developing, coordinating, and enforcing systems, policies, procedures, and productivity standards. Complete performance evaluations in a timely manner.
Stay abreast of current developments and trends in Medi-Cal and Medicare managed care as well as policy and regulatory changes.
Other duties as assigned.

Education and Experience equivalent to:
Master’s Degree in health administration, business administration, or a related field. Minimum of 15 years relevant health care experience administering managed health care programs, with at least 10 years in a management role. Five years of the management experience must be at the Senior Leadership Level.
Experience working with Medicaid, Medicare, and other public programs. Experience with Medi-Cal is preferred.
Knowledge of:
Current developments in the field of managed care.
Principles, procedures, and techniques used in planning, evaluating, and administering a variety of programs such as Medi-Cal (including behavioral health), Medicare Advantage Special Needs Plans, and managed care administrative services for other organizations.
Federal and State laws and regulations pertaining to managed care, Medicaid, and Medicare.
Supervisory principles and practices as well as techniques and methods to organize and manage direct reports.
Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access, and PowerPoint.
Ability to:
Administer the functions/programs of a managed health care organization.
Supervise/provide direction to staff.
Establish and maintain effective working relationships with government agencies, community programs, providers, members, staff, and others.
Communicate effectively with a diverse group of people, verbally and in writing.

Note: The above position description is intended to describe the general nature and level of the work being performed by employees assigned to this job. This is not an exhaustive list of all duties and responsibilities. HPSM reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.

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