Commercial Population Health and Quality Manager
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Job Location:
Albuquerque, NM - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Overview
Presbyterian is seeking a Commercial Population Health and Quality Manager
PHP seeks a Senior Lead - Commercial Population Health and Quality to lead the implementation of cross-departmental programs and services to achieve optimal clinical and utilization outcomes for commercial members. The lead will represent the work of the population health and quality department to commercial clients and lead the development of proposal responses and reporting packages that demonstrate the value of PHPs offerings.
- This is a Full Time position - Exempt: Yes
- Job is based at Rev Hugh Cooper Admin Center
- Work hours: Weekday Schedule Monday-Friday
Ideal Candidate:
- Masters degree.
- 3 years of relevant leadership experience required
- 3 years of Managed Care Organization (MCO) experience required
Qualifications
- Masters degree in healthcare leadership business public health or other relevant field required
- 3 years of relevant leadership experience required
- 3 years of Managed Care Organization (MCO) experience required
- Ability to derive population health insights from aggregated data
- Ability to develop KPIs and use quality metrics to drive a continuous quality improvement cycle
- Knowledge of value-based programs and contracting
- Excellent analytical and organizational skills with strong attention to detail
- Ability to present qualitative and quantitative data to a variety of high-level audiences
- Ability to meet tight deadlines
- Project Management skills preferred
Responsibilities
- Leads the design implementation tracking and evaluation of the population health and quality approach for commercial members
- Designs solutions that meet the specific needs of commercial accounts
- Oversees the implementation of analytics and reporting approaches to convey the value of PHPs population health and quality programming to commercial clients
- Serves as the lead population health and quality contact for commercial clients regularly meeting with clients in the field to understand priorities build relationships and convey PHPs value
- Serves as the author of proposal responses and related to commercial population health and quality
- Maintains knowledge of up-to-date best-practice approaches to achieving best in class clinical and utilization outcomes for the commercially insured population
- Works in partnership with key leaders to develop and implement payment and reimbursement strategies in alignment with the organizations vision goals and strategy
- Deploys cross-departmental strategies to ensure commercial members are aware of and engaged in programming to promote self-management of chronic conditions and completion of evidence-based preventative care and treatment
- Ensures broader Presbyterian offerings including wellness and community programming are integrated into PHPs population health and quality approaches for commercial members
- Serves as the business lead for procurement implementation and evaluation of vendors and partnerships offering clinical services to the commercial population
Benefits
About Presbyterian Healthcare Services
Presbyterian offers a comprehensive benefits package to eligible employees including medical dental vision disability coverage life insurance and optional voluntary benefits.
The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges webinars and screenings - with opportunities to earn gift to earn gift cards and other incentives.
As a mission-driven organization Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers markets and local partnerships. Founded in 1908 Presbyterian is a locally owned not-for-profit healthcare system with nine hospitals a statewide health plan and a growing multi-specialty medical group. With nearly 14000 employees it is the largest private employer in the state serving over 580000 health plan members through Medicare Advantage Medicaid and Commercial plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
Maximum Offer for this position is up to
Compensation Disclaimer
Required Experience:
Manager
Key Skills
- Forecasting
- Hyperion
- Cost Management
- Construction Estimating
- QlikView
- Bus Driving
- Analysis Skills
- HubSpot
- Salesforce
- Market Research
- negotiation
- Financial Planning
About Company
Find the medical care and health plan you and your family need at Presbyterian Healthcare Services, an integrated system of hospitals, healthcare providers and insurance plans serving patients and members in New Mexico.
