Market Clinical Director of Population Health

3 weeks ago


Charleston, West Virginia, United States AmeriHealth Caritas Full time
Job Title: Market Clinical Director of Population Health

We are seeking a highly skilled and experienced Market Clinical Director of Population Health to lead our market-specific clinical operations. This individual will be responsible for supervising prenatal UM and ICM staff, ensuring all market activities conform to enterprise program descriptions, policies, and procedures.




  • Oversight of execution of market-specific clinical programs, including prenatal UM, CM, Foster Care, and Bright Start.
  • Assures compliance of program execution with enterprise policies.
  • Monitors performance metrics across multiple LOBs and assures that appropriate action is taken to address performance opportunities consistent with enterprise policies.
  • Responsible for market-specific contract and NCQA accreditation compliance related to Population Health Clinical Operations.
  • Supervises market-specific Population Health Clinical Operations staff.


Requirements:


  • Bachelor's degree required in Nursing or healthcare-related field.
  • Master's preferred or equivalent work-related experience.
  • Clinical license is required, RN is preferred. LCSW or BH equivalent advanced licensure can be considered.
  • CCM certification preferred within 2 years of hire.
  • Three to five years of progressive management experience (including staff management) in a managed care environment.
  • Experience with Managed Medicaid clinical programs is highly desirable.
  • Experience with Foster Care is highly desirable.
  • Knowledge of LTSS programs is highly desirable.
  • Management experience with Case Management programs preferred.
  • Experience in CM design and implementation is preferred.


AmeriHealth Caritas is an equal opportunity employer and welcomes applications from diverse candidates. We offer a comprehensive benefits package, including flexible work solutions, competitive pay, and opportunities for professional growth and development.



We are committed to creating a workplace that is inclusive and respectful of all associates. If you are passionate about making a difference in the lives of others and have the skills and experience required for this role, we encourage you to apply.


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