Product Specialist, Medicare Programs

Reporting to the Sr. Director, Product and Growth, the Product Specialist Medicare Programs is responsible for tracking, analyzing, and monitoring compliance with Centers for Medicare and Medicaid Services (CMS) regulatory requirements. You will work with impacted functional areas to document tasks, policies, processes and collaborate with these teams to demonstrate compliance within required timeframes.

The Product Specialist monitors announcements and alerts through the CMS HPMS website, conducts analysis, research and assigns tasks to the appropriate areas. You will input and maintain documentation of all HPMS memos, ensure implementation status is up-to-date and provides reporting to functional leaders. Also, you will support product development, implementation, and compliance priorities.

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: $33.65 - $38.94 per hour

WHAT YOU WILL DO:

• Understand CMS regulatory requirements and work with teams to maintain compliance.
• Support competitive analysis and works with Director or Manager to develop presentations and communications for external and internal audiences.
• Monitor KPIs and provide findings to Director/Manager for resolution. Represent Product Team in cross functional workgroups.
• Support community engagement activities, marketing campaigns and product promotional events.
• Engage with our teams and vendors to ensure performance, resolution of issues and clarify intent of product/benefit.
• Support product strategy development.
• Support the Director/Manager with administrative tasks involved in the annual CMS Bid submission. Participate in cross-functional teams for Bid.
• Support program manager and manager with planning and delivery of training for internal and external teams.
• Understand feedback from our team and external team members on benefits to inform benefit recommendations.
• Facilitate meetings across impacted teams to ensure attention to and efficient implementation of CMS and DHCS directives. Prepare and collect information for audits.

WHAT YOU WILL BRING:

• Bachelor's degree in Business, Public Health, Sociology, or other related areas; or equivalent work experience.
• Two years of experience in a Medicare health plan compliance, operations, or product organization.
• Experience working with low-income, vulnerable populations, especially those with low health literacy preferred.

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)

PI278878248