Population Health Program Development Manager

We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and commitment to diversity and inclusion.

The Population Health Program Development Manager will work closely with internal and external stakeholders to profile the health status of plan members, stratify populations, and enhance care coordination. Utilizing quality and clinical information systems, the Population Health Program Development Manager will identify opportunities to improve medical expenses, care quality, and health outcomes. This role will be responsible for understanding national, regional and local trends surrounding health care delivery and building collaborative relationships with external community providers/agencies that align with Independent Health's strategy to advance desired business, clinical and quality outcomes. They will introduce and participate in the evaluation of proposed partnerships, acquisitions, vertical integration strategies including but not limited to vendor engagement, and other integrated care delivery.

Leveraging technology, they will enhance medical management and build relationships with key providers and community organizations. They will analyze existing practices to isolate areas for improvement or enhancement for defined IH member populations and high risk/high need cohorts not well served by the traditional healthcare delivery system. They will document strategies for successful implementation and support special projects and key initiatives.

• Bachelor's degree required. Master's degree or PharmD degree preferred. An additional four (4) years of experience will be considered in lieu of degree.
• Five (5) years of experience in implementation of medical management strategies supporting evidence based best practice required.
• Experience providing pharmaceutical care services preferred.
• Experience in utilization of data analytics to drive decisions.
• Knowledge of managed care including understanding of the physician, provider, payer and employer perspectives.
• Strong clinical knowledge base; kept current through educational endeavors and professional affiliations; strong comprehension of pharmaceutical managed care issues.
• Proven problem-solving track record with high level attention to detail and ability to meet project deadlines.
• Knowledge of Medicare STAR, QARR, HEDIS, NCQA quality measures.
• Knowledge of business/strategic/environmental issues (internal and external).
• Experience with developing strategic and annual business plans.
• Excellent written and verbal communications skills with emphasis on diplomacy, negotiation and persuasiveness, and interaction with multiple levels of management.
• Skilled in analysis, measurement, reporting and planning.
• Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

• Develop and maintain a strategic roadmap that outlines intended areas of focus, program objectives, measurable IH and market opportunity and potential partners with which to engage.
• Work collaboratively with the leadership of Health Care Services, Informatics, and other internal and external stakeholders to develop means to comprehensively profile the health status of plan members, stratify member populations to assist in providing for the unique health needs of individuals and subpopulations, and improve and streamline care coordination.
• Work collaboratively with individuals and departments to maintain and excel in the performance related to Medicare STAR quality ratings, QARR, HEDIS, and other nationally and regionally recognized programs related to population health.
• Using available quality, population health management, patient experience, and other clinical and administrative information systems identify significant opportunities to improve medical expense and quality of care and health outcomes as measured by HEDIS, Medicare Star, and QARR.
• Ensure that program research, development and design is consistent with goals of engaging members/patients with their primary, specialty and behavioral health care to improve health and adopt healthy lifestyles.
• Evaluate and propose appropriate physician, facility, IPA and/or member incentives that aid in achieving improvement in member health and health plan quality goals, as well as support innovation in care delivery.
• Exploit technology including telemedicine, remote patient monitoring and other telehealth modalities to enhance and support medical management by primary care providers, specialists, hospitals, rehab facilities and ancillary providers.
• Develop relationships and collaborations with key providers and community organizations to align care delivery in the achievement of mutual goals.
• Participate in the development of potential partnership, acquisition, implementation, management and ongoing evaluation of non-traditional team-based, patient-centric care delivery especially for high risk, high need and other unique IH members.
• Lead exploration of the need for, as well as implementation and ongoing evaluation of alternative specialty, behavioral health and other innovative care delivery such as pre- and post-acute care for high risk, high need and other unique IH members through partnership, acquisition, vendor engagement or development.
• Develop, lead and measure operational and organizational initiatives in support of the company's strategic plan.
• Lead cross-functional teams in developing cutting-edge programs, models, partnerships, and initiatives, driving growth, and capitalizing on emerging opportunities.
• Work closely with current markets to identify areas of opportunity/gaps and develop and execute strategies to positively influence future procurement responses.
• Conduct and analyze market intelligence; state priorities, contract requirements, CMS regulations, policies, and regulatory landscape; and competitor activities to inform capture and proposal strategies.
• Analyze and gather data, metrics and outcomes to support evidence-based strategies and approaches in proposal responses.
• Provide post-submission consultation on proposals and prepare key personnel for oral presentations/negotiations.
• Document and convey strategies/features to relevant teams, ensuring alignment and support for successful implementation.
• Support special/ad hoc projects and key initiatives.

Immigration or work visa sponsorship will not be provided for this position

Hiring Compensation Range: $85,000 - $115,000 annually

Compensation may vary based on factors including but not limited to skills, education, location and experience.

In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via the Job Hub app.