Manager, Population Health

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and direct population health initiatives aimed at enhancing care quality, access, and outcomes for CareSource members.

• Develop and execute the population health management strategic plan in collaboration with the Director of Population Health and Chief Medical Officer.

• Lead team efforts in care navigation to connect members with essential resources, services, and support.

• Assist in quality improvement projects and work to close gaps in collaboration with Enterprise Quality Improvement teams.

• Execute quality initiatives and interventions focusing on women, children, pregnant women, infants, adolescents, and teens.

• Conduct reviews, audits, and monitoring of quality improvement, performance improvement, and accreditation activities.

• Design and implement strategies for community and provider engagement with the Network and Community Marketing teams.

• Foster community partnerships aimed at addressing health equity and overcoming social determinants of health challenges.

• Utilize analytics and data to enhance engagement among the community, providers, and members.

• Engage in root cause analyses and ensure effective data presentation to tackle accreditation, clinical monitoring, and quality challenges.

• Establish and uphold standards and procedures for accreditation, quality reporting, and documentation.

• Relay strengths and areas for improvement to the Quality Management and Improvement Committee.

• Participate in national, state, and local committees, focus groups, and internal workgroups.

• Provide leadership, guidance, coaching, and developmental opportunities for staff.

• Monitor staff performance, including scheduling, productivity, and quality metrics.

• Carry out additional job-related tasks as needed.

• Travel frequently to homes, offices, and various public locations; travel may exceed 50%.

⛳️ Requirements

• Must reside in the State of Georgia and within the assigned territory, except where business needs dictate otherwise.

• A Bachelor of Science (B.S.) in a health-related discipline is required.

• Equivalent years of relevant professional experience may be accepted in place of the required educational qualifications.

• A minimum of three (3) years in a Managed Care Organization (MCO) or related healthcare field is required.

• At least three (3) years of experience in quality or analytics is required.

• Proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint.

• Experience in data collection, analysis, and process and outcome trending.

• Familiarity with performance improvement principles, quality methodologies, regulations, and standards for health plan quality and accreditation requirements.

• Working understanding of health plan policies and procedures.

• Current, unrestricted Registered Nurse (RN) licensure in state of practice is preferred.

• Influenza vaccination is mandatory during flu season, with annual proof required for designated roles.

• Willingness to travel more than 50% of the time; routine mobile travel exceeding 50% is required.

• Flexibility to work varied hours, including potential evenings and weekends.

• A Master's degree in health services, public health, healthcare administration, or another health-related field is preferred.

• An additional two years of experience in an MCO or healthcare-related environment is strongly preferred.

• Three years of leadership or management experience is preferred.

• Experience with Medicaid is preferred.

• Capability to present data and recommendations clearly and succinctly.

• Strong problem-solving, critical thinking, listening, communication, interpersonal, teamwork, and organizational skills.

• Ability to work both independently and collaboratively in a team setting.

• A customer service and member-focused orientation is essential.

🏝️ Benefits

• A bonus linked to both company and individual performance may be available.

• A comprehensive total rewards package is offered.

• Influenza vaccination requirements and immunization support are provided for designated positions.

• Reasonable accommodations for qualified individuals with disabilities, medical conditions, or sincerely held religious beliefs are available.

• Flexible hours, including potential evenings and/or weekends as necessary.

• Support for continuing education is provided.