Reporting to Sr. Director, Provider Network Operations, the Manager, Provider Relations leads the provider-facing team responsible for delivering high-quality service and support to SFHP's contracted provider network. You will oversee the Provider Engagement Representatives, Provider Experience Liaisons and Provider Network Managers, ensuring outreach, issue resolution, and performance monitoring that enhance the provider and patient experience. You will execute network strategies, driving initiatives, and reporting progress to leadership. You will serve as a key liaison between SFHP and its contracted providers, supporting value-based care and regulatory compliance

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: $113,000 - $140,000 per year

WHAT YOU WILL DO:

• Oversee a team of Provider Engagement Representatives, Provider Experience Liaisons, and Provider Network Managers.
• Foster a culture of accountability, service excellence, and continuous improvement.
• Support leadership development and operational performance across the team.
• Monitor provider performance metrics and trends; implement improvement plans in collaboration with leadership.
• Facilitate Joint Operations Committee meetings, driving consensus on performance priorities and follow-up actions.
• Collaborate with Contracting and Compliance teams to enforce contract terms and regulatory requirements.
• Support resolution of escalated provider issues and grievances.
• Analyze and interpret cost and quality data to deliver relevant insights to providers and leadership.
• Provide high-level recommendations to enhance operational workflows and service delivery.
• Develop and maintain reporting frameworks to track progress on strategic initiatives and network performance.
• Manage implementation of new vendor tools, including CRM systems, in coordination with internal teams.
• Use data-driven decision-making to optimize provider relations and contract execution.
• Partner with Regulatory Affairs to ensure compliance with state and federal requirements.
• Oversee the intake and resolution of provider complaints and perceived service failures, including regular review of complaint data and trends.
• Represent provider relationships across financial performance, quality, clinical management, population health, claims resolution, coding, NCQA accreditation, HEDIS, Stars, and operational improvements.
• Collaborate with Provider Network Operations leadership to identify growth opportunities, retention strategies, and outreach results.
• Support provider audits, surveys, credentialing, contract management, and practice transformation efforts.
• Align new initiatives, advisories, and plan changes with provider expectations and education efforts.
• Contribute to the development and execution of operational policies and procedures that support the provider services model.
• Help set quarterly and annual strategic goals for the provider relations and engagement teams.
• Partner with Marketing to develop consistent provider outreach collateral and engagement strategies.
• Lead provider training activities, including webinars, educational forums, and content development.
• Evaluate provider outreach strategies using data and communicate goals and outcomes across teams.
• Partner with Sales, Stars, and Risk Adjustment teams to support DSNP product performance.

WHAT YOU WILL BRING:

• Bachelor's degree in business administration, healthcare administration, or related field required; or equivalent work experience or equivalent work experience.
• Minimum five years of experience in managed care, with progressive responsibility in provider relations or network management.
• Minimum three years of supervisory or management experience.
• Experience leading cross-functional initiatives and applying project management principles.
• Project Management experience is preferred.
• Experience in data analysis.
• Expertise in relationship management principles, managed care terminology, and familiarity with DSNP and Medi-Cal programs strongly 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)