Senior Population Health Strategy Specialist

Centene Corporation

2d•Hybrid

About The Position

This position is responsible for planning and designing population health strategy initiatives and programs aimed at improving care coordination and health outcomes, including developing efficiencies in both clinical and non-clinical programs. The specialist will monitor the effectiveness of care and identify areas for process improvement to manage costs and ensure compliance with federal and state regulations.

Requirements

Requires a Bachelor's degree and 4 – 6 years of related experience.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Responsibilities

Plans and designs population health strategy initiatives and programs to improve care coordination and health outcomes, including developing efficiencies in programs (clinical and non-clinical).
Monitors the effectiveness of care and identifies areas for process improvement to manage costs and to comply with federal and state regulations.
Develops and designs complex population health strategy initiatives, programs, and operational plans to improve care coordination, health and qualify outcomes.
Manages, identifies, and tracks clinical, quality, documentation and data submission projects to achieve strategic objectives.
Monitors and researches care management trends and analytics to support program initiatives and efficiencies and help identify high risk member populations.
Develops financial budgets and forecasts for strategic planning and initiatives.
Partners with senior leadership team strategic planning initiatives in accordance with federal and state regulations and company policy.
Partners across departments to identify areas for process improvements to manage costs and support initiatives to improve health and quality outcomes.
Tracks and monitors program participation and member outcomes to access the efficacy of programs and interventions and make recommendations for improvement.
Partners with senior leadership team to provide insights to improve coordination of care, member utilization, and improve overall health and quality outcomes.
Collaborates with ensuring clinical initiatives and/or programs are in accordance with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements.
May work across multiple Line of Business and states to encompass program needs into population health strategies.
Performs other duties as assigned.
Complies with all policies and standards.