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; participates in certification, accreditation and audit procedures.
-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; attending, presenting at conferences and/or speaking events when appropriate.
-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.
-Provides leadership and oversight to Population Health programs and teams
-Ensures development of Population Health initiatives to improve member and provider satisfaction and quality care.
-Develops a high performing department by organizing talents to deliver results while establishing and maintaining a collaborative, mission-driven culture.
-Provides direction and oversight to leadership staff in the Population Health Department and support for continued professional growth.
-Responsible for the efficient utilization of resources and develops an annual budget and resource allocations for areas of responsibility; 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 collaboratively with the Information Technology and Analytics Department to develop and implement consistent productivity tools, dashboards, reporting and/or analytics to measure effectiveness and tracking of existing programs and or department activities.
-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; ensuring service level agreements are met; managing vendor invoices; and partnering with Procurement, Legal, and/or leadership teams to develop service level and/or scope of work
agreements as appropriate.
-Leads and/or serves on a variety of appropriate internal and external committees to represent Population Health.
-Serves as business owner for areas of accountability where the department has been identified, such as: DHCS reporting requirements, Memorandums of Understanding (MOUs), NCQA Accreditation, etc.
-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.
-Performs other duties as required.
-Education and Experience: Registered Nurse with a Bachelor’s degree required. Master’s degree and PHN preferred. 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.
-Special Skills, Licenses and Certificates: Current California Registered Nurse License. Public Health Nurse certification preferred. Must have excellent verbal and written skills. 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.
-Work Environment And Physical Demands: Occasional travel required. Ability to use a computer keyboard. Ability to prioritize workload and function effectively with frequent interruptions and direction from multiple team members. More than 50% of work time is spent in front of a computer monitor. Must be able to lift, move, or carry objects of varying size, weighing up to 10 lbs.
All HealthPlan employees are expected to:
-Provide a high level of service to clients;
-Promote teamwork and cooperative effort among employees;
-Maintain safe practices; and
-Abide by the HealthPlan’s policies and procedures as they may from time to time be updated.
$ 166,894.84 – $ 225,306.65
IMPORTANT DISCLAIMER NOTICE
The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.