Director, Population Health for Medicaid

Job Summary:The Population Health Director for Medicaid is primarily responsible for improving the health outcomes of specific Medicaid patient populations, through the development and oversight of program(s) and population health initiatives addressing preventive care, chronic condition management, and wellness. The director will provide clinical expertise to the complex patient population needs and collaborate with stakeholders to improve population health outcomes.Essential Responsibilities:

Oversees Medicaid strategic design, implementation, and evaluation of population health initiatives based on a deep understanding of scientific population health principles.

Sponsor and champion state-initiatives, including cultivating the support necessary to achieve the desired operational objectives for each initiative.

Serve as liaison with DCH, DPH (Department of Public Health), DBHDD, and other DCH contracted CMOs on population health activities.

Support and provide leadership for programmatic initiatives to reduce health disparities (in collaboration with Health Equity Director).

Provide oversight and management of EPSDT program and patient safety quality of care program.

Collaborate with DCH, other CMOs, and other state child-serving agencies to design, implement, coordinate, and evaluate population health initiatives focused on the behavioral health of high-risk children and youth.

Ensures the program is aligned with the standards of the patient-centered medical home care model and fosters the administration of evidence-based healthcare.

Collaborate with leaders to achieve strategic goals as related to the development and implementation of Population Health Management strategy and programs.

Collaborate with Analytics to develop care management scorecards, tools, and processes to measure effectiveness of existing programs and development of potential new program interventions.

Review and analyzes population and patient data related to clinical care and outcomes to evaluate performance, reveal trends, and identify opportunities.

Build interdepartmental and interdisciplinary relationships to assure collaboration and effective/efficient operations within the organization and in the community.

Design pilots and partnership agreements that further the goals of innovative methods to deliver value-based care.

Create and drive evidence-based, scalable, and financially sustainable population health solutions.

Leads meetings and committees, directs the data analysis and reporting, monitors program performance, and looks ahead to mitigate risks.

Develops policies, procedures, and guidelines for population health operations programs.

Evaluates regulatory changes, remains current with current trends and best practices, and evaluates steps needed to implement or incorporate into Population Health programs.

Oversees and navigates technology and software applications utilized in the delivery of population health programs.

Identifies opportunities to leverage technology, innovation, and automation to support population health programs.

Basic Qualifications:

Experience

Minimum seven (7) years of experience in population health management. Strong understanding of epidemiology, data analysis, and health interventions.

Minimum five (5) years of experience leading work related to the Medicaid program.

Minimum five (5) years of progressive experience in population health, service coordination, ambulatory care, long-term care, community public health, case or care management, or coordinating care across multiple settings and with multiple providers.

Education

Bachelors degree in Public Health, Nursing, Health Administration, Social Work, Business Administration, or related field.

License, Certification, Registration

N/A

Additional Requirements:

Development and execution of evidence-based population health management integration programs.

Experience in a large academic health system or integrated heatlh care delivery system.

Ability to work in a team environment, as well as independently.

Demonstrated excellence in communication skills.

Demonstrated ability to listen and communicate needs, from internal and external stakeholders.

Ability to communicate effectively at all organizational levels and in situations requiring instructing and advising.

Knowledge and understanding of Medicaid program.

Preferred Qualifications:

Experience working in a community-based setting for at least two (2) years preferred.

Masters degree in Public Health, Health Administration, Public Administration, Public policy.

COMPANY: KAISERTITLE: Director, Population Health for MedicaidLOCATION: Atlanta, GeorgiaREQNUMBER: 1290086External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.