Director of Population Health (Operations and Clinical Support)
About The Position
The Director of Population Health (Operations and Clinical Support) will develop and implement a comprehensive population health strategy for STAR Kids and STAR/CHIP populations. This role involves designing and scaling interventions, outreach programs, and screening initiatives to improve health outcomes and reduce healthcare costs. The Director will also ensure regulatory compliance, oversee quality improvement, manage costs, and lead initiatives addressing social determinants of health and health equity. Collaboration with internal and external stakeholders, including community organizations and executive leadership, is crucial. The position requires strong leadership to mentor a team and foster a culture aligned with TCH values.
Requirements
- Bachelor’s degree in Nursing or Social Work (required)
- Minimum of 5 years of supervisory or formal leadership experience (required)
- At least 4 years of progressively responsible experience in population health, community/public health, ambulatory care, or healthcare administration (required)
Nice To Haves
- Master’s degree in Nursing (preferred)
- Experience with NCQA accreditation processes and requirements (preferred)
Responsibilities
- Develop and implement a comprehensive population health strategy across STAR Kids and STAR/CHIP populations.
- Design and scale targeted interventions, outreach campaigns, and screening programs to improve outcomes and reduce cost of care.
- Establish measurement frameworks to monitor performance, including HEDIS and quality metrics.
- Partner with executive leadership to drive system-wide population health initiatives.
- Ensure compliance with all state and federal regulatory requirements, including NCQA standards.
- Oversee audits, reporting, and performance improvement initiatives across care coordination programs.
- Monitor timeliness, accuracy, and effectiveness of member outreach, complaints, and regulatory submissions.
- Lead initiatives to reduce avoidable costs of care, including readmissions and inefficient care delivery models.
- Partner with internal teams and external providers to optimize transitions of care and specialty programs.
- Drive process improvements that enhance operational efficiency and financial performance.
- Develop and lead strategies addressing social determinants of health and health disparities.
- Build and maintain partnerships with community organizations to support member wellbeing.
- Utilize data and analytics to identify at-risk populations and implement targeted interventions.
- Collaborate cross-functionally with clinical, operational, and executive leaders across the organization.
- Serve as a thought leader in population health and community engagement.
- Lead, mentor, and develop team members while fostering a culture aligned with TCH values.
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What This Job Offers
Job Type
Full-time
Career Level
Director
