Offer summary

Qualifications:

Bachelor’s Degree in a health services field is required; a Master’s degree is preferred., 10 – 12+ years of experience in the health care field, preferably in managed care, is required., Proficient in Microsoft Office and data analysis, with strong knowledge of relational databases and statistical analyses., Familiarity with quality improvement methodologies and HEDIS®, QARR, CAHPS, and HOS requirements is essential..

Key responsabilities:

Lead the development and performance of population health programs and strategies.

Collaborate with internal and external stakeholders to enhance patient experience and reduce costs.

Analyze population and patient data to evaluate performance and identify opportunities for improvement.

Engage with diverse communities to set priorities and drive planning efforts for health equity initiatives.

Job description

Summary Of Job

Serve as advisor on health equity, SDOH, and population health programming, collaborating with a wide range of internal and external stakeholders, responsible for EmblemHealth’s strategy and mission. Develop and lead programs with focus on improved health outcomes of groups across the community; monitor and identify individual patients within that group based on medical conditions, age, and location. Use data to ensure an equal distribution of health resources among all members of our insured community. Oversee quality improvement to improve care, reduce costs, and deliver evidence-based outcomes.

Responsibilities

Participate and lead the development, performance, and maturation of existing programs.
Provide subject matter expertise in areas such as health equity analytics, community health, bias reduction, and diversity equity and inclusion.
Lead and/or serve on a variety of appropriate internal and external committees to represent Population Health.
Review and analyze population and patient data related to clinical care and outcomes to evaluate performance, reveal trends and identify opportunities.
Collaborate with internal and external organizations to execute innovative programs and build partnerships.
Drive change management to balance community needs with government system changes.
Lead the population health strategy and NCQA’s Population Health Management program.
Collaborate with clinical, operations, and community teams to enhance the patient experience and reduce per member cost.
Identify root causes, analyze data, and develop metrics to reduce health disparities.
Prepare reporting to present findings and highlight successes and opportunities for improvement or intervention.
Engage with diverse communities to set priorities and drive planning efforts.
Monitor performance indicators to ensure exceptional quality outcomes.
Prepare and execute operational plans to achieve measurable objectives on an established timetable.
Develop programs to address barriers to healthcare as determined by patient need.
Assist in applying for and reporting on grant-funded programs.
Actively participate in quality improvement committees, subcommittees and workgroups to support process improvement.
Review and update operational processes for quality management activities. Define and document newly established processes.
Remain current with new trends and best practices and incorporates into Population Health programs.
Support preparation, organization and follow-up in acquiring and maintaining NCQA accreditation and compliance with local, state and federal regulatory authorities, includes support of the health plan’s HEDIS, QARR, and Star processes.

Qualifications

Bachelor’s Degree in a health services field (Required)
Master’s degree (Preferred)
10 – 12+ years of experience in the health care field, preferably in managed care experience (Required)
Ability to work with staff in several locations where the company has offices, necessitating site visits
Proficient in Microsoft Office - Word, PowerPoint and Excel, Access (Required)
Proficient in data analysis. Strong working knowledge of relational database and statistical analyses (Required)
Must be familiar with and have a strong knowledge of QI process improvement methodology strategies, including but not
limited to PDSA and DMAIC (Required)
Must be familiar with the HEDIS®, QARR, CAHPS and HOS requirements (Required)
Must possess analytical skills to collect, organize and present data in a clear and concise manner (Required)
Ability to assess all work and prioritize as necessary to meet reporting timeframes and deadlines (Required)

Additional Information