Director of Population Health

JOB SUMMARY & ESSENTIAL FUNCTIONS

The Director of Population Health provides enterprise leadership for Valle del Sols population health and value-based care strategy. This position is responsible for translating payer contracts clinical quality priorities utilization data and population health needs into coordinated operational strategies that improve patient outcomes strengthen access to care reduce avoidable utilization and maximize organizational performance under value-based reimbursement models.

The Director leads the development implementation and continuous improvement of a comprehensive population health infrastructure across primary care behavioral health psychiatry substance use services pharmacy care management and community-based programs. Working collaboratively with clinical operational financial quality technology and payer partners the Director drives measurable improvements in quality utilization patient engagement and financial performance while advancing Valle del Sols mission and strategic priorities.

Strategic Leadership & Population Health

• Develop and implement an enterprise-wide population health strategy aligned with Valle del Sols mission strategic plan HRSA requirements payer contracts clinical priorities and value-based purchasing goals.
• Establish a standardized operating model for population health across primary care behavioral health psychiatry substance use treatment pharmacy and community-based services.
• Translate population health priorities payer requirements and organizational goals into actionable operational strategies.
• Identify opportunities to improve quality access health equity patient engagement and financial performance through innovative population health initiatives.
• Promote culturally responsive trauma-informed recovery-oriented and patient-centered approaches throughout all population health activities.

Population Health Operations

• Lead enterprise initiatives to identify risk stratify engage and manage attributed and assigned patient populations.
• Develop and maintain systems for identifying high-risk rising-risk medically complex behaviorally complex and disengaged patients.
• Oversee population health workflows supporting preventive care chronic disease management care coordination and care gap closure.
• Coordinate patient outreach activities with clinic operations care management and the patient contact center to improve patient engagement and completed services.
• Ensure outreach lists registries and care-gap reports are accurate prioritized assigned and actively managed.

Care Coordination & Utilization Management

• Lead enterprise strategies that improve timely follow-up after emergency department visits inpatient admissions behavioral health hospitalizations and other care transitions.
• Develop reliable processes for receiving reviewing and acting upon admission discharge and transfer (ADT) notifications.
• Identify frequent utilizers and collaborate with multidisciplinary teams to develop individualized intervention plans.
• Partner with hospitals crisis systems health plans and community providers to improve care coordination continuity of care and transitions between care settings.
• Monitor utilization trends and evaluate intervention effectiveness in reducing avoidable emergency department visits hospitalizations and overall healthcare costs.

Value-Based Care & Payer Performance

• Partner with Finance Contracting Clinical Operations and Executive Leadership to implement and optimize value-based reimbursement strategies.
• Interpret payer contracts quality measures attribution methodologies incentive models utilization targets and shared savings opportunities.
• Monitor contract performance and proactively identify operational barriers risks and opportunities for improvement.
• Participate in payer meetings joint operating committees contract performance reviews and strategic planning discussions.
• Lead initiatives to increase attributed and assigned Medicaid and Medicare member populations.

Clinical Quality & Performance Improvement

• Collaborate with Quality Clinical Operations and provider leadership to improve performance on UDS HEDIS CMS AHCCCS managed care and contract-specific quality measures.
• Establish performance metrics dashboards scorecards and reporting systems that support organizational accountability and continuous improvement.
• Utilize clinical claims pharmacy utilization and social determinants of health data to identify performance gaps and drive targeted interventions.
• Evaluate program effectiveness and implement quality improvement initiatives that improve clinical outcomes and operational performance.

Data Analytics & Population Health Technology

• Partner with Information Technology Analytics and EHR teams to improve data integrity usability reporting capabilities and population health technology.
• Validate payer attribution files care-gap reports utilization reports quality metrics and performance calculations.
• Oversee the development and maintenance of registries dashboards and predictive analytics that support population health management.
• Utilize data to monitor outcomes identify trends and support strategic decision-making.

Leadership & Cross-Functional Collaboration

• Provide leadership coaching and performance management for assigned population health staff.
• Establish departmental goals performance expectations and operational priorities aligned with organizational objectives.
• Provide matrixed leadership to clinical pharmacy care management quality operational contact center and analytics teams supporting population health initiatives.
• Foster collaboration across departments to improve patient outcomes organizational performance and value-based care success.

Professional Responsibilities

• Demonstrates leadership consistent with Valle del Sols mission vision values and Emotional Quotients.
• Builds collaborative relationships with executive leadership clinical leaders providers health plans community organizations and regulatory agencies.
• Participates in executive committees strategic planning activities payer meetings and quality improvement initiatives.
• Maintains current knowledge of population health value-based care healthcare quality regulatory requirements and emerging industry trends.
• Maintains all required certifications and continuing education applicable to the position.
• Performs other duties as assigned.

QUALIFICATIONS

Education

Required:

• Bachelors degree in Nursing Public Health Healthcare Administration Business Administration Health Informatics Population Health Social Work or a related healthcare field from an accredited institution.

Preferred:

• Masters degree in Public Health (MPH) Healthcare Administration (MHA) Business Administration (MBA) Nursing (MSN) Public Administration (MPA) or a related field.
• Additional coursework or training in population health healthcare quality value-based care healthcare analytics healthcare finance or organizational leadership.

Experience

Required:

• Minimum seven (7) years of progressively responsible experience in healthcare operations population health care management quality improvement clinical operations value-based care or a related healthcare field.
• Minimum five (5) years of leadership experience overseeing multidisciplinary teams population health initiatives clinical operations or quality improvement programs.
• Demonstrated experience developing and implementing population health strategies that improve clinical outcomes and operational performance.
• Experience working with value-based reimbursement models payer partnerships quality incentive programs or alternative payment models.
• Experience utilizing clinical claims utilization and quality data to support operational and strategic decision-making.

Preferred:

• Experience within a Federally Qualified Health Center (FQHC) integrated healthcare system managed care organization or accountable care organization (ACO).
• Experience leading initiatives related to UDS HEDIS CMS Star Ratings AHCCCS HRSA or other healthcare quality programs.
• Experience with care management chronic disease management behavioral health integration or social determinants of health initiatives.
• Experience implementing population health technologies registries predictive analytics or care management platforms.
• Experience managing budgets contracts grants or payer relationships.

Licensure/Certification

Preferred:

• Active clinical licensure in Arizona (RN LCSW LMSW LPC NP PA PharmD or other applicable healthcare license).
• Certified Professional in Healthcare Quality (CPHQ).
• Certified Professional in Healthcare Management (CPHM) or Fellow of the American College of Healthcare Executives (FACHE).
• Lean Six Sigma Green Belt Black Belt or equivalent process improvement certification.
• Project Management Professional (PMP) or equivalent project management certification.
• Additional certifications in population health care management quality improvement healthcare analytics or value-based care.

Other Requirements

• Must be at least 18 years of age.
• Must be authorized to work in the United States.
• Must be able to pass pre- and continued employment screenings successfully.

KNOWLEDGE SKILLS AND ABILITIES

• Comprehensive knowledge of population health management value-based care healthcare operations and care coordination principles.
• Knowledge of healthcare quality programs including UDS HEDIS CMS AHCCCS HRSA and other regulatory and payer performance measures.
• Knowledge of healthcare reimbursement methodologies value-based purchasing risk adjustment attribution shared savings and alternative payment models.
• Knowledge of chronic disease management behavioral health integration care transitions utilization management and social determinants of health.
• Ability to develop implement and evaluate enterprise-wide population health strategies that improve patient outcomes and organizational performance.
• Ability to analyze clinical financial claims utilization pharmacy and operational data to identify trends prioritize interventions and support strategic decision-making.
• Ability to develop and monitor dashboards scorecards key performance indicators (KPIs) and outcome measures.
• Ability to lead multidisciplinary teams and foster collaboration across clinical operational financial quality information technology and payer-facing departments.
• Ability to build collaborative relationships with providers executive leadership health plans hospitals community organizations and other external stakeholders.
• Strong leadership coaching mentoring and change management skills with the ability to influence organizational performance without direct authority.
• Strong strategic planning critical thinking project management and problem-solving skills.
• Excellent written verbal presentation and interpersonal communication skills with the ability to communicate effectively at all organizational levels.
• Ability to exercise sound judgment maintain confidentiality and make informed decisions in complex and evolving healthcare environments.
• Proficiency in electronic health records (EHR) population health management platforms healthcare analytics tools Microsoft Office Suite and business intelligence software.
• Ability to manage multiple priorities lead complex initiatives and consistently meet organizational deadlines.
• Ability to communicate effectively with patients providers employees community partners and payer representatives.
• Ability to maintain accurate documentation and ensure compliance with organizational policies regulatory requirements and contractual obligations.
• Ability to work collaboratively in a multidisciplinary and cross-functional team environment.
• Commitment to promoting culturally responsive trauma-informed recovery-oriented and patient-centered care.

WORKING CONDITIONS & PHYSICAL REQUIREMENTS

Work Environment

This position may operate in clinical office or community settings including clinics administrative offices outreach locations client homes partner agencies and community sites. Employees may interact with individuals experiencing behavioral health challenges emotional distress or complex social needs. Standard safety precautions and personal protective equipment (PPE) may be required as applicable.

Physical Requirements

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Typical requirements may include:

• Sitting standing walking bending and reaching for extended periods
• Operating computers mobile devices and standard office or clinical equipment
• Travel to various Valle del Sol locations or community sites when required
• Lifting or moving materials or equipment up to 25 pounds

Schedule & Travel

Work schedules may vary based on program needs and may include evening or weekend hours. Some positions may require local travel between Valle del Sol sites or community locations.

Equipment

Employees may operate standard office clinical and communication equipment including computers phones printers electronic health record systems laptops and mobile devices.

COMPLIANCE REQUIREMENTS

Employees must maintain compliance with all Valle del Sol policies and applicable regulatory requirements which may include:

• Licensure certification credentialing and/or privileging requirements applicable to the position.
• Required immunizations and occupational health clearances.
• Tuberculosis (TB) testing and Hepatitis B screening or declination when applicable.
• Arizona Level I Fingerprint Clearance Card when required by law or program.
• Valid drivers license and acceptable driving record when operating a vehicle for company business.
• Completion and maintenance of required training certifications and continuing education.

Failure to obtain or maintain required credentials clearances or compliance requirements may impact eligibility for employment or continued assignment in the role.

Equal Opportunity Employer

Valle del Sol is an Equal Opportunity Employer and considers all qualified applicants without regard to race color religion sex sexual orientation gender identity national origin age disability or veteran status. Valle del Sol is committed to providing a work environment free from discrimination and harassment.

Reasonable Accommodations Statement

To perform this job successfully an individual must be able to perform the essential functions of the position. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform these functions.

If you require a reasonable accommodation to apply for a position or to participate in the interview process please contact us at

Additional Information

This job description has been reviewed to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employees ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions responsibilities skills and abilities or a contract of employment. Management reserves the right to modify add or remove duties as necessary.

Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

Benefits

• 401(k)
• 401(k) matching
• Medical Insurance
• Dental Insurance
• Vision Insurance
• Paid Life Insurance
• Paid Disability Insurance
• Paid time off
• Employee assistance program
• Employee discount
• Professional development assistance
• Referral program
• Particpation in the NHSC Loan Repayment Program for qualifying positions!

Required Experience:

Director