Executive Director, Patient Financial Services (0941 Manager VI)

The Department of Public Health prioritizes equitable and inclusive access to quality healthcare for its community and values the importance of diversity in its workforce. All employees at the Department of Public Health work to advance equity, inclusion, and diversity with a specific lens and focus on race, ethnicity, gender, sex, sexuality, disability, and immigration status. 

• Application Opening –  October 17, 2025
• Application Deadline – Application filing will close on or after October 31, 2025
• Salary – 0941 Manager VII (Range A Salary between $193,700 and $247,260 annually)
• Appointment Type: Permanent Exempt
• Recruitment ID: PEX-0941-EXEMPT

The Mission of the San Francisco Department of Public Health (SFDPH) is to protect and promote the health of all San Franciscans. SFDPH strives to achieve its mission through the work of multiple divisions - the San Francisco Health Network, Population Health, Behavioral Health Services, and Administration. The San Francisco Health Network is the City’s only complete system of care and has locations throughout the City, including Zuckerberg San Francisco General Hospital and Trauma Center, Laguna Honda Hospital and Rehabilitation Center, and over 15 primary care health centers. The Population Health Division (PHD) provides core public health services for the City and County of San Francisco: health protection, health promotion, disease and injury prevention, and disaster preparedness and response. Behavioral Health Services operates in conjunction with SFHN and provides a range of mental health and substance use treatment services.

Under policy direction of the ZSFG Chief Financial Officer, the Director of Patient Financial Services oversees the effective and efficient management of SFHN revenue cycle operations which represents daily operations and activity of the three (3) system entities within the SFHN.

The Patient Financial Services Department supports Zuckerberg San Francisco General Hospital and Trauma Center, Laguna Honda Hospital and Rehabilitation Center, and the Community Primary Care Clinics. Currently, there are 550,000 registered visits per year and 42,000 accounts billed per month. The Executive Director of Patient Financial Services is responsible for the management of approximately 240 FTEs with varying positions/classifications.

The Executive Director of Patient Financial Services performs the following essential job functions: 

1. Provides the necessary vision and leadership to effectively motivate and direct the Patient Financial Services Department in developing and achieving goals and objectives that are congruous with the values, mission and strategic plan of the SFHN and the Department of Public Health (DPH);
2. Oversees the entire revenue cycle process of approximately $2.6 billion in revenue; develops strategies to ensure that best practices are utilized throughout revenue cycle management and identifies revenue opportunities not yet captured; provides executive management with an early warning and practical options to resolve potential revenue cycle issues;
3. Ensures that all activities are performed in compliance with federal and state regulatory requirements and oversees the development/maintenance of systems supporting efficient, accurate, and compliant revenue cycle processes used to collect appropriate and sustainable revenues from patients and third parties;
4. Develops and implements department goals, objectives, policies and priorities; determines service levels and resource allocation; monitors the efficiency and effectiveness of the departmental organization structure, staff assignments, service levels and administrative systems;
5. Plans, organizes, directs, and controls the operations of the Patient Registration areas including, but not limited to: inpatient admissions, emergency room, primary care clinics, subspecialty clinics, ancillary departments, psychiatric emergency services, and the Behavioral Health Center;
6. Manages all patient eligibility functions including: insurance verification of government and non-government payers; eligibility program enrollments of uninsured patients to State, Federal and County sponsored programs (e.g. Medi-Cal, Managed Care Medi-Cal, Covered California, California Children Services, Healthy San Francisco and other State/County programs);
7. Manages the billing and collection of self-pay, government, and non-government payers as well as inter-department liability accounts, University of California, San Francisco (UCSF) Research Study and Grant programs;
8. Manages the Patient Financial Services Department budget, maintaining variances within acceptable levels each month; directs the allocation of resources to achieve timely outcomes and measurable goals within budget; adjusts plans and programs to meet emerging or new needs, while continuing to address major departmental priorities; and participates in budget development by providing detailed justification and persuasive arguments for proposals or initiatives;
9. Evaluates, monitors, and coaches the work of Patient Financial Services department managers and supervisors to improve performance;
10. Communicates regularly with executive-level management regarding the Department’s activities and coordination of efforts with other City departments in addressing the needs of the City; represents the Department before legislative boards and outside organizations;
11. Demonstrates professional and inclusive behavior in all communications with residents, co-workers, and the public

The Director of Patient Financial Services (0941) performs other duties as assigned and required.

EDUCATION: Possession of a bachelor’s degree from an accredited college or university,

EXPERIENCE: Four (4) years of managerial experience in patient financial services, revenue cycle management, or eligibility operations, all of which must be supervisory

EDUCATION SUBSTITUTION: Additional qualifying experience as described above may be substituted for the degree on a year-for-year basis. Thirty (30) semester units or forty-five (45) quarter units equal one (1) year.

DESIRABLE QUALIFICATIONS: The stated desirable qualifications may be considered at the end of the selection process when candidates are referred for hiring:

• Management experience in patient accounting
• Public sector or safety net/Medicaid experience
• Experience with information technology systems/software used to manage hospital patient accounting or admitting/admissions

Important Note: Please make sure it is absolutely clear in your application exactly how you meet the minimum qualifications. Applicants may be required to submit verification of qualifying education and experience at any point during the recruitment and selection process. Please be aware that any misrepresentation of this information may disqualify you from this or future job opportunities. 

How to apply:

Applications for City and County of San Francisco jobs are only accepted online at careers.sf.gov.

Our e-mail communications may come from more than one department so please make sure your email is set to accept messages from all of us at this link.

Applicants may be contacted by email about this recruitment. Please consider using a personal email address that you check regularly rather than a work or school account.

Applicants will receive a confirmation email that their online application has been received in response to every announcement for which they file. Applicants should retain this confirmation email for their records. Failure to receive this email means that the online application was not submitted or received.

Additional information regarding Employment with the City and County of San Francisco: 

• Information about the Hiring Process 

• Conviction History 

• Employee Benefits Overview 

• Equal Employment Opportunity 

• Disaster Service Workers

• Reasonable Accommodation

• Right to Work

• Copies of Application Documents

• Diversity Statement

If you have any questions regarding this recruitment or application process, please contact the analyst, Steven Scoles at [email protected] or (628) 271-6828.

We may use text messaging to communicate with you on the phone number provided in your application. The first message will ask you to opt in to text messaging.

The City and County of San Francisco encourages women, minorities and persons with disabilities to apply. Applicants will be considered regardless of their sex, race, age, religion, color, national origin, ancestry, physical disability, mental disability, medical condition (associated with cancer, a history of cancer, or genetic characteristics), HIV/AIDS status, genetic information, marital status, sexual orientation, gender, gender identity, gender expression, military and veteran status, or other protected category under the law.