Director of Population Health

Job Responsibilities

• Provides oversight to the care management team and ensures all team members are clinically integrated into local GLFHC practices and their role is optimized on the PCMH team
• Works in collaboration with members of the CSS division to ensure alignment with Social Determinants of Health (SDOH) strategies and grant funded care management programs
• Behavorial health care management strategies are aligned with the Behavioral Health clinical service line and engages the BH clinician leader in reviewing complex cases
• Actively collaborates and engages site Medical Directors, other clinical leadership and Chief Medical Officer to ensure physician involvement, as appropriate, in clinical initiatives
• Uses data analytics to evaluate and adapt the delivery of care management program based on the needs of patient populations
• Ensures coordination of care coordination activities with CPs and other community based services organizations and government funded programs
• Utilizes population health value-based data analytics to enhance the delivery of care coordination, complex case management, transitions of care and care coordination activities and new program development opportunities based on patient risk profiles
• Oversees population health coordinator functions including developing a framework for identifying and closing care gaps within the patient population as informed by data analytics
• Maintains coordination of care management performance indicators related to patient caseloads, patient engagement, graduation rates and other process measures
• Oversees the CP program manager and ensures compliance with ACO contract requirements
• Incorporates a health equity lens in the design of key population health initiatives, including appropriate data collection and recommendations to address disparities and identify and solution for member barriers to care
• Ensures special initiatives such as SDOH, flex benefits, Care Needs Screening process are fully integrated into the care management workflow

Qualifications and Experience

• Current Registered Nursing licensure in the state of Massachusetts RN, BSN required
• Advance degree in related area (business, clinical) highly desirable
• Certification on Case Management (CCM) highly desirable
• Five years or greater clinical experience in related field
• Five years or greater management experience
• Minimal five years of managed care experience supervising care management teams
• Working knowledge with performance dashboards and analytic functions
• Demonstrable prior experience overseeing care management functions and working in value based contracts
• Demonstrable leadership experience that demonstrates collaborative leadership, complex problem solving, stakeholder management, critical thinking and conflict resolution
• Ability to lead multi-disciplinary teams and effectively manage high impact initiatives through the deployment of cross functional improvement teams
• Effective communication skills, including ability to engage teams in problem solving and driving key outcomes
• Experience working in regulated practice environments, including the ability to interpret regulation and audit operational performance (documentation, policy adherence, etc.)
• Confident autonomous leader with strong interpersonal skills and proven ability to work in a matrixed model where stakeholder engagement is critical
• Strong organizational skills with ability to prioritize and multi-task as needed
• Working knowledge of excel, PowerPoint, and Visio
• Demonstrated experience working with diverse patient populations and workforce