The Healthfirst Population Health department synthesizes industry and business trends, reviews regulatory changes and best practices, and makes informed recommendations on clinical and quality initiatives to help Healthfirst remain competitive in the health insurance industry. This department works closely with other clinical teams to help the organization achieve top quality performance on key indicators like HEDIS, QARR, and Medicare Advantage Star ratings. The Manager of Population Health Strategy leads organizational efforts to improve Healthfirst's performance on quality rating programs. The Manager will be assigned to support specific product lines such as Medicare, Medicaid, Managed Long Term Care, and Commercial.
Duties and Responsibilities:
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Leads development, implementation, refinement, and monitoring of short- and long-term strategies and initiatives to improve performance on quality rating programs aligned with Healthfirst's overall corporate strategy. Collaborates closely with Clinical, Pharmacy, Analytics, Enterprise Delivery System, Member Experience, and other key departments across the organization to deliver on initiatives.
Monitors status of current and projected performance on Quality Ratings and analyzes, synthesizes, and presents data to senior leadership and quality committees.
Collaborates with stakeholders to identify appropriate provider partners for initiatives that would impact key strategic areas of population health.
Reviews data to evaluate impact of interventions and to drive continuous performance improvement.
Acts as subject matter expert on assigned Healthfirst quality ratings programs, including program and measure proposals /changes. Communicates with relevant stakeholders on proposed changes and their impact.
Drafts and refines comments to regulatory agencies, measurement bodies, coalitions, and other industry groups about quality ratings programs which incorporate input from organizational stakeholders including internal regulatory department.
Champions our culture of quality by supporting workgroups in improving processes and operations, researching, and communicating industry best practices, and recognizing teams and individuals for their contributions to quality.
Additional duties as assigned.
Minimum Qualifications:
Bachelor's degree
Preferred Qualifications:
Relevant previous experience such as research, analytics, or project management experience on clinical quality initiatives
Master's degree in a related field
Ability to work independently in a fast-paced environment
Supervisory, coaching, or team lead experience. Experience leading cross-functional work groups
Healthcare experience associated with population health outcomes, quality improvement, or policy and analyzing data and making data-driven recommendations for quality improvement
Intermediate/Advanced Excel and Powerpoint skills
Excellent leadership, project and time management, communication, critical/creative thinking and problem-solving skills
Experience working with a hospital, health insurance company, or healthcare focused government agency or non-profit (e.g. DOH)
Familiarity with Business Intelligence and Data Visualization tools (such as Qlikview or Tableau); statistical analysis/analysis software (like SAS, SRSS, R); and/or programming languages (like SQL and VBA)
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
EEO Law Poster and Supplement
All hiring and recruitment at Healthfirst is transacted with a valid "@healthfirst.org" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.
Hiring Range:
- Greater New York City Area (NY, NJ, CT residents): $100,900 - $145,775
- All Other Locations (within approved locations): $86,500 - $128,690
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.