Population Health Strategy Manager

Description and Requirements

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.

• 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 heath.
• 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 necessary.

• Bachelor's degree from an accredited institution

• Relevant previous experience such as research, analytics, or project management experience on clinical quality initiatives
• Master's degree in a related field from an accredited institution
• 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)