San Francisco Health Plan (SFHP) Selects RedMane Technology for Eligibility, Enrollment, and Case Management System Project
RedMane Technology LLC, a Chicago-based software solutions and systems integration firm, was awarded a contract by the San Francisco Health Plan (SFHP) to implement an eligibility, enrollment, and case management system to support the Healthy San Francisco (HSF) program.
RedMane will configure and implement its mCase cloud-based platform to support applications, eligibility determination, enrollment, case management, provider network management (Medical Home management), communication, reporting, and billing for the HSF program.
Operated by the San Francisco Department of Public Health (DPH), the HSF program provides affordable health coverage to over 160,000 low- and moderate-income families residing in San Francisco. The new system will support almost 400 users performing health program management, application assistance, pharmacy and clinic eligibility verification, and customer service.
Kevin Lisle, Director of Product Management, Analytics, and Enrollment Operations for SFHP, said mCase will help the SFHP effectively manage the eligibility determination and enrollment for the Healthy San Francisco program.
“We are excited to partner with RedMane to implement an integrated, secure, and modern platform to help us efficiently provide health care services to the uninsured. mCase will allow us to focus on making health care accessible to those that need it most.”
“We are proud to support this innovative health access program,” said Tony Lakier, RedMane’s president. “We look forward to bringing our expertise in implementing and supporting eligibility, enrollment, and case management systems to this most important project.”
About the San Francisco Health Plan
San Francisco Health Plan (SFHP) has a rating of 4 out of 5 in NCQA’s Medicaid Health Plan Ratings 2021. SFHP is a licensed community health plan providing affordable health coverage to over 160,000 low- and moderate-income families residing in San Francisco. SFHP is designed for and by the residents it serves—many of whom would not be able to otherwise obtain health care for themselves or their families.
Through SFHP, members have access to a full spectrum of medical services including preventive care, hospitalization, prescription drugs, family planning, and substance abuse programs. SFHP’s mission is to improve health outcomes of the diverse San Francisco communities through successful partnerships. San Francisco Health Plan is also the third-party administrator for the nationally recognized Healthy San Francisco program. For more information on SFHP, visit www.sfhp.org.
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website(ncqa.org) contains information to help consumers, employers and others make more-informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/ and on LinkedIn at linkedin.com/company/ncqa.
RedMane provides software solutions and systems integration services that address complex, real-world challenges. Our health and human services expertise includes eligibility and enrollment, case management, child welfare, and child support. We are a problem-solving company. Technology is just one of our tools. To learn more about RedMane, visit redmane.com.