Sr. Director of Population Health Management & Medical Director

Health One Alliance•Dalton, GA

14d

About The Position

The Senior Director of Population Health Management has operational and strategic oversight for Case Management, Care Coordination, Utilization Management, and the organization’s Population Health Management strategy. This role is responsible for designing, executing, and continuously improving enterprise-wide programs that drive health outcomes, quality performance, and manage the overall medical expense of the organization. This leader translates regulatory guidance and clinical best practices into scalable care management, utilization management, and care coordination, delivering measurable results for members, providers, and the business.

Requirements

Current MD or DO degree with an unencumbered and unrestricted license to practice medicine in Georgia and Tennessee required
5 years - Clinical experience required
5 years - Healthcare administration, including UM experience highly preferred
Experience in internal medicine, family medicine or emergency medicine required
Board Certification in a recognized specialty by the American Board of Medical Specialties or the American Board of Osteopathic Specialists
Ability to interpret and explain complex government policies
Knowledge of health plan operations and utilization management strategies

Nice To Haves

Experience in specialty areas such as oncology, rehabilitation, and physical medicine preferred

Responsibilities

Serve as a key member of the executive leadership team, partnering across clinical, financial, and operational domains to design and implement clinically driven financial improvement strategies that optimize care quality, reduce avoidable costs, and sustain long term organizational performance.
Develop the multi-year Population Health strategy and annual operating plan aligned to Alliant’s strategic objectives.
Establish policies, programs and standard operating procedures across Case Management, Utilization Management, and Care Coordination.
Chair cross-functional steering forums; ensure clear decision rights, cadence, and accountability.
Act as a strategic thought partner to the Sr Director of Data Governance, Risk Adjustment & Medical Economics on the development and implementation of a Medical Economics strategy for the organization.
Oversee clinical programs: complex case management, disease management, transitions of care, and utilization management; ensure evidence-based protocols, appropriateness, and equity.
Build referral pathways and reporting for specialty programs and ensure efficient vendor collaboration and notifications.
Develop provider engagement strategies (scorecards, incentives, care gap workflows, clinical collaboration) in partnership with the Sr. Director of Data Governance, Risk Adjustment & Medical Economics to drive improvement in Alliant’s medical trend.
Lead the development of quality improvement initiatives that enhance member health outcomes and achieve measurable gains in HEDIS® performance, ensuring compliance with NCQA standards and successful annual audit outcomes.
Lead day-to-day operations across PopHealth teams; drive capacity planning, workforce management, and continuous improvement.
Maintains regular and predictable attendance
Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
Works to encourage and promote Company culture throughout the organization
Other duties as may be assigned