Director-Population Health & Care Management Strategy (Full-Time, Remote/Hybrid, North Carolina Based) at Alliance Health in Morrisville, North Carolina

Job Description:

The Director, Population Health and Care Management Strategy is a key role in evaluating member outcomes and initiating population health interventions intended for Alliance Health beneficiaries. 

The Director is pivotal in the development, stabilization, and strategy for Care Management programs. This includes evaluation and optimization of current activities and interventions resulting in proposals for the development of expanded CM programs to support positive member outcomes. The Director will facilitate a seamless approach to population health for the organization.

This position will be primarily remote.  The selected candidate must be a NC resident and be willing to work onsite out of the Alliance Home Office (Morrisville, North Carolina) as needed. Additionally, travel may be required within NC based on business needs and community-based partnership events.  

Responsibilities & Duties

Data Analysis and Reporting

• Work with internal and external data science resources to identify and document data requirements, ensuring population health, member outcome, and program outcome data is captured


• Analyze and interpret data into clear priorities, interventions, and business operations


• Translate and articulate data-driven insights into easy-to-understand communication, appropriate for the intended audience


• Develop reports and presentations to articulate data findings and recommendations

Program and Member Outcome Evaluation

• Applies Care Management Standards of Practice, inclusive of Integrated Care Management Standards of Practice into care management program evaluations


• Identify and analyze data regarding member outcome impacts of Care Management programs


• Analyze and communicate member outcome trends and patters


• Facilitate collaboration with Care Management and Clinical Leadership to identify factors influencing care management impact on member outcomes


• Document identified strengths, barriers, and process improvement needs to drive positive member outcomes


• In collaboration with SVP Pop Health-CM and Sr. Director, develop program evaluation report with recommended strategy and interventions

Population Health

• Remains current with and applies Population Health research, best practices, and industry evolution to population evaluation and program strategy


• Align Population Health strategy to with NC Medicaid Managed Care Quality Strategy. Internal collaboration to ensure Alliance QM Strategy reflects needs identified through population health evaluation


• Collaborate with Director Community Health & Social Impact to ensure that population health findings on member non-health related unmet needs are incorporated into Community Health strategy


• Collaborate with Director Health Equity to ensure Population Health is approached through the lens of health equity and that population health evaluation findings on member trends are incorporated into Health Equity strategy


• Analyze and communicate member outcome trends and patters


• In collaboration with Sr. Director, develop organizational Population Health Strategy

Internal and External Stakeholder Collaboration

• Coordination of multidisciplinary teams and committees


• Work collaboratively with a cross-functional team of internal partners to include, not limited to, care management and clinical leadership, provider network, and medical economics


• Build rapport, trust, and effective working relationships with external partners to include, not limited to, DHHS, state and county partners, and NC SHIP Community Council


• Participate in-person and virtually at internal and external meetings across NC catchment areas

Program Strategy, Policy, and Operational Procedure

• Working with internal SMEs, develop strategy to for program implementation and improvement to include, not limited to, State and Federal Contracts and Requirements, and NCQA Accreditation Standards


• Apply population and member outcome findings to departmental and organizational strategies


• Collaboration with product management to maximize utilization of full functionality of Population Health and Care Management Platform, Jiva, to support strategy, staff efficiencies, monitoring of member health status, and interventions to drive positive member outcomes


• Assist in developing, revising, and maintaining program descriptions, policies, and operational procedures

People Leader

• In collaboration with cross-departmental leadership, strategize and lead change management efforts. Influence across leadership levels and direct member support roles for investment and sustainability of change


• Provide direct supervision of team members. This may include routine review of progress towards target timelines and goals, as well as project alignment with business operation requests and requirements.  


• In collaboration with the Sr. Director, ensure the department has the needed tools and resources to achieve organizational goals and to support employees and ensure compliance with licensure, regulatory, and accreditation requirements

Manage and Develop Staff

• Work with Human Resources to attract, maintain, and retain a highly qualified and well-trained workforce 


• Ensure staff are well trained in and comply with all organization and department policies, procedures, and business processes


• Organize workflows and ensure staff understand their roles and responsibilities


• Ensure the department has the needed tools and resources to achieve organizational goals and to support employees and ensure compliance with licensure, regulatory, and accreditation requirements


• Actively establish and promote a positive, diverse, and inclusive working environment that builds trust 


• Ensure all staff are treated with respect and dignity


• Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members


• Work to resolve conflicts and disputes, ensuring that all participants are given a voice


• Set goals for performance and deadlines in line with organization goals and vision


• Effectively communicate feedback and provide ongoing coaching and mentoring to staff and support a learning environment to advance team skills and professional development


• Cultivate and encourage efforts to expand cross-team collaboration and partnership

Travel 

Travel between Alliance offices, attending meetings on behalf of Alliance, participating in Alliance sponsored events, etc. may be required

• Travel to meet with members, providers, stakeholders, attend court hearings etc. is required

Minimum Requirements

Education & Experience

Required:

Master's degree in mental health, public health, social work, psychology, education, sociology, business or public administration and five (5) years of experience in a community, business, or governmental program in health related fields, social work, or education, including three (3) years of supervisory experience and (3) years of experience with with population health data analysis.

Or

Bachelor’s degree in Nursing from an accredited college/university and seven (7) years of experience in a community, business, or governmental program in health related fields, social work, or education, including three (3) years of supervisory experience and (3) years of experience with population health data analysis.

LCSW, LMFT, LCMHC, LPA, or RN required.

Preferred:

Two (2) years of experience with health plans or health systems in the context of an integrated care approach for individuals with complex behavioral, cognitive, and physical health needs. 

• Project Management and/or Lean Six Sigma Certification. 


• Experience with strategy recommendations. 


• Understanding of and ability to identify and communicate needs for Data Dashboard, CM, or EHR system configuration.


• Experience with Care Management program operations.

Knowledge, Skills, & Abilities

• Advanced proficiency with Excel


• Intermediate proficiency with Word and Power Point


• Basic proficiency with MS Teams and Outlook Functionalities


• Ability to utilize computer equipment and web-based software to conduct work.


• Ability to work independently without a high degree of supervision.


• Ability to coordinate, facilitate, and lead meeting and committees with internal and external stakeholders. 


• Highly skilled in managing multiple projects and priorities.


• Excellent ability to effectively communicate in easy-to-understand language in accordance with the intended audience. 


• Accountability for professional development and expanding knowledge related to research, industry standards, and best practices.

Salary Range

$113,520-$144,738/Annually 

Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.  

 An excellent fringe benefit package accompanies the salary, which includes:    

• Medical, Dental, Vision, Life, Long and Short-Term Disability


• Generous retirement savings plan


• Flexible work schedules including hybrid/remote options


• Paid time off including vacation, sick leave, holiday, management leave


• Dress flexibility

Want to learn more about what it's like work as part of the Care Management Team? Click on our video to learn more: https://youtu.be/1GZOBFx61QU

Education

Required

• Bachelors or better in Health Administration


• Masters or better in Human Services

Licenses & Certifications

Required

• Driver License


• Lic Clinical MH Counselor


• Lic Clinical Social Wkr


• Lic Marr & Family Ther


• Lic Psychological Assoc


• Registered Nurse

See job description

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