Director of Population Health

Government Employees Health Association•Summit, NJ

9d•Remote

About The Position

Government Employees Health Association, Inc. (G.E.H.A) is a nonprofit member association that provides health and dental benefits that millions of federal employees and retirees, military retirees and their families have counted on since 1937. Offering one of the largest health and dental benefit provider networks available to federal employees in the United States, G.E.H.A empowers health and wellness by meeting its members where they are, when they need care. G.E.H.A has one mission: To empower federal workers to be healthy and well. The Director of Population Health directs the design, implementation, and execution of the clinical care management and health coaching activities of the company, including case management, disease management, health coaching, and population health. This role designs and implements proven, clinical strategies and ensures quality and cost-effective care across the care continuum. The Director fosters collaboration with interdepartmental leadership to resolve issues and develop innovative benefits, implementing strategies to support organizational goals. Strategic and operational oversight includes care management, health coaching, employee health and wellbeing, and vendor collaborations.

Requirements

Bachelor’s degree in nursing or business
10-15 years of healthcare experience with 5+ years of experience in a leadership role.
Demonstrated ability to build and implement population health programs that improve health outcomes and reduce costs.
Proven analytical skills with the ability to influence, lead, and direct individuals across multiple functional areas.
Strong proficiency in contract review and vendor management, including oversight of external vendor partners and related programs.
Excellent communication and team-building skills, with a record of diplomacy, sound judgment, and integrity.
Experience supporting HEDIS and CAHPS performance, including knowledge of NCQA HEDIS measurement data sets.
Experience in health plan accreditation and benefit design.
Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office. A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required. Latency (ping) response time lower than 80 ms
Hotspots, satellite and wireless internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Nice To Haves

Master’s degree in nursing or a related health field
Federal health plan experience.

Responsibilities

Collaborative Leadership: Build and maintain effective relationships with both internal and external stakeholders, fostering open communication, trust, and shared accountability. Partner with cross-functional leaders to resolve issues efficiently and develop strategies that support organizational objectives.
Strategic Program Oversight: Lead the development, implementation, and execution of clinical programs and population health initiatives, ensuring alignment with the company's mission and driving quality outcomes, cost efficiency, and member satisfaction across the care continuum.
Performance Monitoring and Improvement: Establish, track, and analyze key performance metrics for care management, health coaching, and population health programs. Use data-driven insights to identify trends, drive continuous quality improvement, and communicate results to executive leadership.
Care Management Excellence: Ensure the effectiveness and efficiency of care management activities, grounded in sound business and clinical principles. Develop and monitor departmental goals and metrics, making necessary adjustments to meet monthly, quarterly, and annual targets.
Team Leadership: Lead, mentor, and develop a diverse team of direct and indirect staff to achieve departmental and organizational goals, cultivating a positive and inclusive work environment.
Standardization and Policy Development: Ensure that the care management department has robust policies and procedures in place to standardize workflows and drive high performance.
Data Analysis and Program Evaluation: Evaluate internal and external data and relevant literature to identify gaps in cost utilization and care management programs. Research and implement evidence-based strategies to address identified gaps.
Budget Management: Oversee departmental budgeting processes, ensure adherence to approved budgets, explain variances, and develop corrective action plans as needed.
Program Implementation and Integration: Drive the implementation of new programs, including program design, contract development, ROI projections, and integration with other departments.
Vendor Management: Identify the need for vendor partnerships to enhance cost containment strategies, develop, and manage vendor relationships, and ensure contractual compliance and oversight of vendor-provided services.
HEDIS and CAHPS Performance Support: Oversee integrated care processes and clinical interventions to support HEDIS and CAHPS performance, aligning with quality and accreditation standards.
Product and Benefit Development: Represent the care management department in the development of new products and benefits, ensuring that benefit language supports care management initiatives.
Accreditation and Compliance: Evaluate department alignment with accreditation requirements and implement strategies to support and maintain accreditation status. Ensure compliance with professional licensing requirements and state laws.
Educational Program Development: Develop and maintain educational programs for the department to ensure comprehensive orientation and ongoing competency, meeting all professional licensing requirements.
Employee Engagement and Development: Foster a positive workplace that promotes employee satisfaction and supports the development of staff strengths and talents.
Stakeholder Representation: Serve as the primary representative of the care management department with internal and external customers, promoting department initiatives and achievements.

Benefits

Competitive pay/salary ranges
Incentive plan
Health/Vision/Dental benefits effective day one
401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
Robust employee well-being program
Paid Time Off
Personal Community Enrichment Time
Company-provided Basic Life and AD&D
Company-provided Short-Term & Long-Term Disability
Tuition Assistance Program