Manager, Social Determinants of Health

Manager, Social Determinants of Health

Location (City, State)

San Jose, CA

Department

Community Based Programs - 505

Employment Duration

full-time

Salary Range: $130,622 - $202,465 The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change.

FLSA Status: Exempt Department: Community Based Programs (CBP) Reports To: Director, Community Based Programs

General Description of Position

The Manager, Social Determinants of Health (SDOH) is responsible for management of the Community Supports development and implementation including oversight of all Community Supports vendors for fourteen (14) Community Supports programs. The Manager is responsible for SCFHP initiatives and programs that address member social conditions and needs with the goal of reducing health disparities and improving health equity for SCFHP members. The position includes responsibility for leading and managing staff that support the SDOH and Community Supports projects directly and in collaboration with other SCFHP business units and community stakeholders.

Essential Duties and Responsibilities

To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below.

1. Lead and facilitate new community-based Community Supports programs by including program modeling, business case analysis, implementation and outcome/success measurements. Develop and maintain all appropriate documentation, including timelines, project scope, decision logs and work plans, including the development of process documents such as process maps, workflows and desktop procedures.
2. Manage operations, staff and systems required for Community Supports program implementation including Community Supports authorization and delivery, provider engagement and submission of claims and encounter data in accordance with DHCS-developed service definitions, eligibility criteria and reporting requirements.
3. Lead and develop an adequate network of community-based Community Supports providers with sufficient capacity to meet the needs of all members authorized to receive a Community Supports program including outreach to potential providers, determination of provider readiness, infrastructure needs to meet capacity, provider certification and vendor agreements.
4. Manage all aspects of engagement with Community-Based Organizations (CBOs) and public entities that provide Community Supports services and stakeholders related to these programs, including identification, conducting stakeholder meetings and trainings, and developing and implementing programs, and program oversight.
5. Provide strong oversight of Community Supports delivery and provider network to ensure quality of services rendered and ongoing compliance with all legal and contractual obligations for SCFHP and Community Supports providers including: required reporting, quality monitoring, corrective actions and other oversight activities.
6. Identify issues, trends, and opportunities to advance health equity and address SDOH, both externally within partnerships and internally with departments. Develop recommendations relative to identified issues, trends, and opportunities. Participate in SDOH sector learning and collaboration.
7. Lead SDOH strategy development and implementation in collaboration with the SDOH Cross Functional Team, internal departments and external stakeholders. Provide staff support and leadership for the team, managing all meetings and communications.
8. Lead and facilitate partnerships and collaborative relationships with nonprofit agencies, government entities and CBOs to address member's social needs and advance health equity.
9. Oversee SDOH data strategy and create frameworks for collecting SDOH data to inform decision making and project evaluation.
10. Develop and track outcomes and metrics for SDOH and Community Supports programs, support improvement activities and prepare evaluations and reports on progress including data analytics.
11. Manage vendors used for Community Supports and SDOH projects including software and platforms that support operations, such as findhelp, to ensure they perform according to contract compliance and effectively to meet plan department needs.
12. Perform other related duties as required or assigned.

Supervisory/Management Responsibilities

Carries out supervisory/management responsibilities in accordance with the organization's policies, procedures, applicable regulations and laws. Responsibilities include:

1. Recruiting, interviewing, and hiring.
2. Developing a high performing department culture and staff. This includes setting the standard for staff/peers and motivating employees to maximize organizational goals and objectives.
3. Effectively assimilating, training and mentoring staff and (when appropriate), cross training existing staff and initiating retraining. This includes coaching to help increase skills, knowledge and (if applicable) improve performance.
4. Setting goals and planning, assigning, and directing work consistent with said goals. This includes responding to employees' needs, ensuring they have the necessary resources to do their work.
5. Appraising performance, rewarding and disciplining employees, addressing complaints and resolving issues. This includes providing regular and effective feedback to employees and completing timely and objective performance reviews.

Requirements Required (R) Desired (D)

The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.

1. Bachelor's Degree (R)

2. Master's degree in business, health care, public health, social welfare or related field (D)

3. Minimum two years of progressively responsible and direct work experience with the essential duties and responsibilities described above. (R)

4. Demonstrated experience successfully leading/managing projects, initiatives, and/or leading or directing the work of others. (R)

5. Knowledgeable of local health care community and the field of public health with particular interest in working to address health disparities and addressing the needs of low-income communities.

6. Demonstrated experience of strong project management skills, preferably within a managed care setting with ability to direct and manage large-scale, complex, cross-functional, multi-departmental projects to completion with minimum supervision. (R)

7. Strong analytical and problem-solving abilities. (R)

8. Ability to think creatively and work strategically, to help drive innovative solutions yielding measurable results to the organization. (R)

9. Ability to work with a high level of independence with strong collaborative and relationship management skills. (R)

10. Ability to understand, interpret, and apply applicable rules and regulations, and establish and evaluate priorities. (R)

11. Advanced working knowledge and proficient with Microsoft Suite applications, and the ability to operate all applicable software. (R)

12. Superior oral and written communication skills, including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments and outside entities over the telephone, in person or in writing. (R)

13. Ability to effectively plan for and facilitate meetings and deliver information/presentations to management, regulators, or staff (R).

14. Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R)

15. Ability to take initiative and exercise good judgment when making decisions within the scope of the position. (R)

16. Ability to comply with all SCFHP policies and procedures. (R)

17. Ability to perform the job safely with respect to others, to property, and to individual safety. (R)

18. Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events. (R)

19. Knowledge of the healthcare industry, including CalAIM programs such as Population Health Management. (D)

20. Experience with Health Plan NCQA accreditation and Health Equity Accreditation. (D)

Working Conditions

Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to regular contact with co-workers, managers, external partners, and vendors, in person, by telephone, and via work-related electronic communications.

Physical Requirements

Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation:

1. Mobility Requirements : regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R)
2. Lifting Requirements : regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R)
3. Visual Requirements