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Morgan Consulting Resources, Inc. has been retained to conduct the search for the Chief Financial Officer for San Francisco Health Plan. This is a CA-based hybrid position with presence in the San Francisco office 5-6 times/year for Governing Board meetings, regularly 1-2 times a week, and/or as needed as a member of the SFHP Executive team. This is an outstanding opportunity to join a highly respected organization and build a robust and strategic finance function to support the health plan’s growth and expansion.

About the Organization:

Established in 1994 by the San Francisco Board of Supervisors, San Francisco Health Plan (SFHP) is an award-winning, managed care health plan whose mission is to improve health outcomes of the diverse San Francisco communities through successful partnerships.

We were created by the City and County of San Francisco with one purpose: to provide high-quality medical care to the largest number of low-income San Francisco residents possible, while supporting San Francisco’s public and community-minded doctors, clinics, and hospitals.

SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and our more than 145,000 members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services through the Medi-Cal and Healthy Workers HMO programs. We also provide third-party administrative services to the Healthy San Francisco and City Option programs, which provide health care access to over 13,000 uninsured adults, as well as premium assistance and medical reimbursement accounts for over 345,000 San Francisco employees.

We are a public, not-for-profit, NCQA Accredited Medicaid HMO Health Plan that is committed to universal coverage. Through long-standing partnerships with the San Francisco Health Network, the Department of Public Health, San Francisco Community Clinic Consortium, local community providers, and other community-based organizations, we help ensure low-income San Franciscans have access to high-quality health care.

Our Mission: The mission of San Francisco Health Plan is to improve health outcomes of the diverse San Francisco communities through successful partnerships.

For more information about the organization, please visit: https://www.sfhp.org.

About the Position:

The Chief Financial Officer is a strategic and innovative senior finance leader who will play a key role in San Francisco Health Plan’s (SFHP) strategic direction and financial success in the Medi-Cal and Medicare Advantage lines of business. The CFO will serve as a thought partner to the CEO and will drive improvement throughout the health plan in order to achieve the organization’s mission and vision through short-term and long-term goals. In addition to overseeing finance, the CFO will build and manage robust analytics and actuarial functions to support the organization’s growth and expansion and establish alternative provider payment methodologies and strategies.

The CFO is a key member of the SFHP Executive Team and provides leadership and critical input on the organization’s lines of business and growing demands for SFHP services. The CFO is responsible for directing the financial activities of SFHP in a manner that anticipates and supports current and future organizational objectives. The CFO is expected to comply with the highest ethical and applicable technical and regulatory standards while ensuring the financial viability of SFHP through accurate forecasting, prudent investments, and strategic use of financial resources.

 

Essential Duties & Responsibilities

• Organizational Financial Planning and Oversight:
• Works with executive leadership to develop, plan, and execute short, medium, and long-range organization strategies; ensures the development and implementation of associated business plans, tactics, and policies as they relate to finance.
• Provides strategic financial input and leadership on decision making to the Chief Executive Officer, executive leadership, and the SFHP Board.
• Serves as principal Finance lead for Medi-Cal and Medicare Advantage contract negotiations and other large and highly complex service contracts in collaboration with other appropriate senior staff.
• Responsible for leading and driving financial best practices.
• Oversees Medicare Advantage finance functions including risk score development, CMS MLR, HCC and LIS accruals, and attestations reporting and participates in related initiatives including Medicare bid process.
• Monitors, interprets, and analyzes performance related to Medi-Cal and Medicare Advantage membership, revenue, expenses, medical costs, and utilization.
• Oversees the preparation of annual budget and business plan, presents to the Board, and ensures monthly compliance and/or appropriate documentation and explanation of variances from budget.
• Ensures adequate reserves (IBNR) for liabilities associated with medical claims.

Oversight of Accounting Operations:

• Oversees preparation of financial statements and reports results to the SFHP Finance Committee and SFHP’s Board.
• Ensures that GAAP, GASB, FASB as well as compliance with state and federal financial record keeping and reporting regulations are met such as Tangible Net Equity reserves.
• Maintains a reliable cash flow projection process and reporting mechanism that includes minimum cash threshold to meet operating needs.
• Oversees the selection, maintenance, and upgrades of financial and accounting systems.
• Oversees the cash management and treasury function including the establishment of bank accounts and business relationships required to administer financial functions of SFHP.
• Recommends and administers investment policies to maximize earnings on idle funds.
• Secures and maintains adequate insurance coverage for SFHP services and property.
• Oversees internal and external audit function to ensure the timely and accurate completion of annual fiscal audits and other financial information.

Oversight of Business Decisions, Analytics Operations, & Vendor Spend:

• Advises the CEO on service contracts and internal programs with emphasis on analyzing the business side to make sure there is a balance between the clinical and financial components of the organization.
• Identifies, recommends, monitors, and tracks effective medical cost analysis and product and risk alignment with financial performance targets through coordination with internal functions supporting the business, such as actuarial, medical management, network management, underwriting, etc.
• Provides financial analysis and recommendations in support of management’s evaluation of strategic and business initiatives, while monitoring and evaluating risk and delegation arrangements and recommends appropriate financial protections.
• Leads development and implementation of performance measures and enhances processes that drive accountability measurements throughout the organization.
• Performs financial impact analysis for new contracts and supports negotiations.
• Responsible for identifying medical cost trends and leadership of medical cost improvement initiatives.
• Oversees the analysis of proposed state capitation rates and the development of analysis and arguments to influence the state’s rate-setting process.
• Oversees the analysis of budget to actual healthcare expenses; monitors financial trends and recommends corrective action when appropriate. Effectively communicates the Plan’s financial performance to the CEO, Finance Committee, and SFHP’s Board.
• Education & Experience
• Bachelor’s degree in Finance or related field is required, Master’s degree preferred.
• Minimum six (6) years’ experience in public accounting or finance to include at least five (5) years in health care finance; or equivalent combination of education and experience.
• Ten (10) plus years of financial management experience including strategic and business planning, accounting and financial analysis and reporting in managed care or health care financial environments.
• Ten (10) or more years of leadership experience with success in building and leading high performance finance and analytics teams through strategic and cultural shifts in organizations.
• Demonstrated experience with the management and negotiations of Medicaid and Medicare Advantage contracts; strong knowledge of value based contracting strategies and negotiations as well as partial/full capitation and shared saving programs; experience with Medicare Advantage bid process and CMS MLR and financial reporting; experience supporting and executing Medicare Advantage growth strategies including product development, benefit design, and the analysis of provider performance.
• Experience overseeing actuarial process within Medicare Advantage.

Salary range $299,847-$366,479. Based on internal equity and experience, an appropriate salary expectation is between $299,847-$333,163.

If you or someone you know has the qualifications for this role, I would love to set up a time to talk. Thank you so much for your time.

Lisa Coyne, Principal/Executive Recruiter
Morgan Consulting Resources, Inc.
lisa@morganconsulting.com

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