Director of Population Health
About The Position
The Director of Population Health is a hands-on leadership position responsible for managing and optimizing our participation in commercial payor quality incentive programs and value-based care contracts. This role involves partnering with commercial health plans to maximize performance on quality metrics while leading our 4-person population health team to improve patient outcomes and capture available financial incentives. The Director will work closely with clinical staff, practice leadership, and external payor partners to develop targeted interventions that close care gaps, improve quality measures, and enhance our performance in programs such as Medicare Advantage Stars, commercial HMO/PPO quality incentives, and alternative payment models. This position requires both strategic thinking and tactical execution to drive measurable improvements in quality scores, risk adjustment accuracy, and incentive program revenue while supporting our 550-employee medical group's mission to deliver high-quality, cost-effective care.
Requirements
- Bachelor's degree in Healthcare Administration, Public Health, Nursing, Clinical or related field (Master's degree preferred)
- At least 3 years of experience in population health, quality improvement, or payor contract management within a medical group or similar ambulatory care setting
- Demonstrated experience working with commercial health plans on quality incentive programs (e.g., HEDIS, Stars, P4P programs)
- Strong understanding of quality metrics, care gap closure, and risk adjustment methodologies
- Proven ability to lead small teams and manage multiple projects in a fast-paced clinical environment
- Proficiency with population health platforms, EMR reporting tools, and data analytics
Nice To Haves
- Master's degree in Healthcare Administration, Public Health, or related field
- Experience in a medical group of similar size (250-1000 employees)
- Direct experience managing commercial Medicare Advantage, Medicaid managed care, or commercial HMO quality programs
- Familiarity with value-based payment models and ACO programs
- Knowledge of risk adjustment coding and HCC capture strategies
- Certification in healthcare quality (e.g., CPHQ) or population health management
Responsibilities
- Develop and execute strategies to maximize performance on commercial payor quality incentive programs and value-based contracts
- Lead the 4 person population health team in daily operations including care gap outreach, registry management, and quality reporting
- Partner with commercial health plans to understand program requirements, performance benchmarks, and opportunities for improvement
- Collaborate with providers and clinical staff to implement workflows that improve HEDIS measures, Stars ratings, and other quality metrics
- Analyze performance data to identify gaps in care, prioritize interventions, and track progress against quality targets
- Coordinate with revenue cycle and coding teams to optimize risk adjustment documentation and HCC capture
- Manage vendor relationships for population health technology platforms and analytics tools
- Prepare regular reports for leadership on quality performance, incentive program results, and financial impact
- Ensure compliance with payor contract requirements and quality program guidelines
- Provide training and support to clinical staff on quality measure documentation and care gap closure
- Support the organization's participation in ACO,, or other value-based payment initiatives
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Number of Employees
251-500 employees
