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Found in: Jooble US O C2 - 2 weeks ago
Director of Population Health Management
The Director of Population Health is the key business leader who oversees the organization’s Population Health Management strategy and is responsible for providing leadership, alignment, support, strategic development and implementation of associated activities and interventions. Provides clinical guidance and strategic direction for departmental activities by applying their understanding of population health management priorities, health care policy, financing, and regulations to promote optimal health outcomes for members.
Works collaboratively with leaders across the organization to achieve strategic goals, alignment, and prioritization as related to the development and implementation of Population Health Management strategy and associated programs.
-Utilizes data to support quality patient outcomes and ongoing evaluation of the organization’s Population Health Management strategies by defining goals, developing and evaluating metrics, standards and methods to achieve success.
-Recommends and develops new programs for specialized patient populations to improve quality, health equity and/or patient outcomes as related to the organization’s goals.
-Prepares and presents a summary of the Population Health Management strategy with associated activities and outcomes to appropriate Committees at least annually.
-Stays abreast of health care policies, regulations and changes as it relates to population health management such as those issued by CMS, DHCS, NCQA, CDPH, and/or other associated agencies or regulators; Jointly accountable for ensuring and supporting Partnership’s compliance with regulators and contractual requirements as well as accreditation through NCQA.
-Provides subject matter expertise on matters related to population health management by keeping abreast of innovative industry practices, standards and benchmarks; Builds strategic relationships with community-based organizations, public agencies, and key community stakeholders, and the Regional Leaders to increase their understanding of Partnership’s population health management activities; identifying and acting upon opportunities for participation or partnership in external initiatives/activities in alignment with the organizational objectives.
-Participate in and/or represent Partnership at off-site regulatory, association, community meetings, and events relevant to population health management and/or other local convening’s and initiatives.
-Assists in comprising and reviewing Partnership’s Population Needs Assessment and works collaboratively with the Executive Team, Regional Leaders, Local Health Jurisdictions and community partners to ensure alignment, adequate resources and making recommendations for performance metrics as appropriate.
-Ensures development of Population Health initiatives to improve member and provider satisfaction and quality care.
-Provides direction and oversight to leadership staff in the Population Health Department and support for continued professional growth.
-analyzes data for decision regarding FTEs, staffing and departmental operations.
-With support from departmental leadership, develops, implements, and monitors departmental policies and procedures which support and meet the organizations goals and business objectives.
-Works with the Project Management Office to initiate activities or requirements that impact multiple departments across the organization.
-Participates in vendor management as required by reviewing vendor performance levels; managing vendor invoices; and partnering with Procurement, Legal, and/or leadership teams to develop service level and/or scope of work
Partners with the Chief of Health Services Officer and/or Chief Medical Officer to identify short and long-term department goals and to provide strategic direction on initiatives when needed.
-Registered Nurse with a Bachelor’s degree required. At least five (5) years of experience in a leadership/management role required. Experience in a managed care, health care provider network and/or working with Medi-Cal population preferred.
-Experience in working with diverse and/or community groups. Experience public speaking and/or presenting materials to a variety of audiences. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policies are required to operate a vehicle and travel on company business.
-Performance Based Competencies: Excellent written, verbal, and interpersonal communication skills including the ability to express oneself clearly and concisely when providing service to internal departments, members, providers and outside entities over the telephone, in person or in writing. Ability to understand, analyze, and operationalize regulatory requirements. Ability to analyze and interpret data. Experience in staff management including hiring, supervision, coaching, performance evaluation, key performance indicators and quality monitoring. Deep understanding of population health principles and activities including the use and associated outcomes of various interventions for sub-populations, risk stratification methodologies, and intersection of population health activities with quality and health equity. Working knowledge of NCQA accreditation, HEDIS, CAHPs, and have a contemporary understanding of regulatory and compliance activities.
-Occasional travel required. Ability to use a computer keyboard. More than 50% of work time is spent in front of a computer monitor. Abide by the HealthPlan’s policies and procedures as they may from time to time be updated.
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