Clinical Program and Population Health Strategist-Government Programs

Summary

Presbyterian is hiring a Clinical Program and Population Health Strategist-Government Programs to join their team. This role is full-time, exempt, and based at Reverend Hugh Cooper Administrative Center. It operates on a weekday schedule from Monday to Friday.

Responsibilities

• Build population health strategies for ACA, Medicaid, and D-SNP populations aligned with enterprise priorities
• Identify high-impact opportunities to improve outcomes for complex and vulnerable populations
• Ensure alignment with regulatory requirements and product-specific goals
• Support development and refinement of the Clinical Initiative Portfolio
• Prioritize initiatives based on impact and ROI
• Define success metrics aligned with HEDIS, Stars, risk adjustment, and utilization goals
• Design evidence-based clinical programs and interventions
• Partner with program and operational leaders to support implementation and scaling
• Inform build vs. buy decisions for clinical capabilities
• Translate clinical strategies into provider-facing approaches
• Support development of provider tools, workflows, and reporting
• Provide input into value-based care models and provider performance strategies
• Serve as liaison to Government Programs teams
• Ensure alignment between benefit design, clinical programs, and population health outcomes
• Collaborate with analytics, network, and operations teams
• Partner with analytics teams to define measurement frameworks
• Translate insights into actionable recommendations
• Ensure strategies align with CMS and Medicaid requirements
• Support audits, reporting, and program integrity efforts
• Embed health equity into all strategies and program designs
• Identify disparities and recommend targeted interventions
• Partner with community organizations and internal teams
• Maintain Medicare Stars and HEDIS performance
• Maintain Medicaid quality measures
• Close gap in total cost of care and utilization trends
• Maintain Clinical Initiative Portfolio performance and ROI
• Maintain health equity outcome measures

Qualifications

• Bachelor’s degree required; Master’s degree (MPH, MHA, MBA, or related) preferred
• 5–10+ years of experience in population health, healthcare strategy, or clinical program design
• Experience with Medicare (D-SNP) and/or Medicaid programs
• Strong understanding of HEDIS, Stars, risk adjustment, and utilization drivers
• Experience working in a matrixed organization
• Strategic thinking and portfolio prioritization
• Clinical program design and innovation
• Data-driven decision making
• Cross-functional collaboration and influence
• Strong communication and executive presence
• Health equity focus

Benefits

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance, and other optional voluntary benefits. Presbyterian also offers an Employee Wellness rewards program to enhance personal well-being through wellness activities and challenges.