Population Health Management Coordinator

About the role

The Population Health Management Coordinator (PHMC) at AHF blends the organization's mission with care coordination. The PHMC works closely with the Population Health Management Registered Nurse to ensure all members have access to comprehensive services based on their needs and preferences across the continuum of care. This role is vital for advancing care quality, access, and outcomes by bridging gaps between clinical services and community-based resources through direct field engagement.

Responsibilities

• Conduct in-person visits to provider offices, community organizations, and high-risk member populations to support care coordination, promote adherence to evidence-based guidelines, and address social determinants of health.
• Enhance AHF's reputation by impacting improved member health outcomes and health equity, leading to longer, healthier, and happier lives.
• Ensure that AHF Core Values and Mission are top of mind with all activities.
• Collaborate with interdisciplinary teams to identify care gaps, facilitate timely interventions, and ensure continuity of care, particularly for vulnerable and high-utilization populations.
• Use data-driven outreach, relationship building, and real-time problem solving in the field to enhance member engagement, reduce avoidable emergency department utilization, and support organizational quality metrics and value-based care initiatives.

Requirements

• Licenses and certifications: Managed Care experience preferred. Bilingual Spanish required.