Offer summary

Qualifications:

Master’s degree in public health, health care management, social work, or a related field., 10 years of relevant experience in clinical/human services research or healthcare operations management., Minimum of 5 years of experience leading teams, particularly analytics staff., Experience in collecting and analyzing Child Welfare and Behavioral Health data is a plus..

Key responsibilities:

Develops and directs the Outcomes Monitoring and Evaluation Program for Healthy Blue Care Together.

Oversees data analytics staff and supports ongoing outcomes monitoring and evaluation efforts.

Monitors and evaluates member and population-level health outcomes and generates reports as required.

Collaborates with various teams and external stakeholders to support health plan delivery and initiatives.

Job description

Job Description

Develops vision and strategy and drives implementation of the Outcomes Monitoring and Evaluation Program within Healthy Blue Care Together, North Carolina's statewide Medicaid Managed Care Children and Families Specialty Plan. Brings expertise to the development of short- and long-term monitoring and evaluation strategies, focused on member health, well-being, and permanency. Collaborates with subject matter experts and programs throughout the health plan, state partners, and external stakeholders to ensure achievement of health plan and member goals.

What You'll Do

Develops and directs the Outcomes Monitoring and Evaluation Program for Healthy Blue Care Together, to include development of Program objectives, indicators, tools, and methods for data collection, analysis, and reporting.
Oversees data analytics staff, in support of matrixed health plan teams and ongoing outcomes monitoring and evaluation efforts.
Supports development and implementation of a state-level, System of Care consortium focused on monitoring and evaluation of health, well-being, and permanency outcomes among the North Carolina foster care and former foster care populations.
Monitors and evaluates member- and population-level health, well-being, and permanency outcomes. Supports ongoing evaluation of health plan impact, return on investment, cost of care, and quality relative to targeted outcomes.
Uses data and other insights to identify strategies for improving health plan performance relative to targeted health, well-being, and permanency outcomes.
Generates routine and ad hoc reports in accordance with regulatory reporting requirements and other role-based requirements.
Keeps abreast of advances in data collection, analysis, and reporting strategies, with an emphasis on best practices for short- and long-term monitoring and evaluation of member and population health, well-being, and permanency outcomes.
In partnership with Integrated Care Management, Behavioral Health, Physical Health, Intellectual and Developmental Disorders, Substance Use, Pharmacy, Provider Network, Quality Management, Judicial, and DSS Engagement teams, as well as external stakeholders, provides data and interpretation to support health plan delivery and initiatives that impact member outcomes.
Oversees vendor relationships for outcomes monitoring and evaluation activities.
Presents results and interpretation of ongoing outcomes monitoring and evaluation activities to health leadership and external stakeholders.
Must be a North Carolina Resident

What You Need

Master’s degree in relevant field including public health, health care, health care management, social work, or other related field.
10 years of relevant experience required (i.e. clinical/human services research, healthcare operations management, clinical data management, quality management, and others).
Minimum of 5 years of experience leading teams and/or directly managing staff, particularly analytics staff.

Bonus Points

Experience collecting, analyzing, and reporting Child Welfare data
Proven experience measuring Behavioral Health data and reporting outcomes
Ability to build and foster cross functional relationships

What You'll Get

The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community 
Work-life balance, flexibility, and the autonomy to do great work 
Medical, dental, and vision coverage along with numerous health and wellness programs 
Parental leave and support plus adoption and surrogacy assistance 
Career development programs and tuition reimbursement for continued education 
401k match including an annual company contribution

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$131,900.00 - $250,600.00

Skills

Clinical Research, Healthcare Operations, Healthcare Project Management, Health Plan Operations, Patient Safety, Performance Improvements, Performance Metrics, Policy Development, Policy Implementation, Process Improvements, Quality Improvement, Quality Improvement Implementation, Quality Management, Quality Measurements, Quality Programs, Regulatory Compliance

Required profile