Demo

Population Health Strategy Consultant (Remote - Field Based)

CareFirst BlueCross BlueShield
Baltimore, MD Remote Full Time
POSTED ON 2/8/2025
AVAILABLE BEFORE 3/9/2025
Purpose

Resp & Qualifications

The Population Health Strategy Consultant works closely with physicians and health systems ("providers") enrolled in CareFirst's government (Medicare and Medicaid) & value-based programs to understand patterns in their population's health data and effectuate practice transformation strategies that improve quality and reduce global health care costs. The Practice Consultant collaborates with internal subject matter experts to provide consulting services to physicians, key physician practice staff, executive level health system administrators, and other stakeholders to achieve program or contract goals.

We are looking for an experienced professional to work remotely from within the greater DMV metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities.

Essential Functions

  • Practice Transformation: Employs consulting skills to manage behavior change and influence practice work flow improvements that optimize outcomes and value. Thoughtfully implements processes and technologies in practices to assure the highest state of provider readiness to participate in various CareFirst networks, government programs and other opportunities that may emerge.
  • Data and Work flow Analysis: Manages aggregate performance of all value-based contracts across the market and develops/adjusts plan as needed. Conducts a thorough review of clients' opportunities, utilization patterns, and outcomes to inform provider and health system decision making. Researches any variances and seeks resolution. Models the financial impact of proposed changes in practice patterns
  • Market Analysis and Development: Builds and manages relationships within the local health care market, understanding community health and wellness needs. Identifies opportunities to improve the access, quality and efficiency of patient care and provider communication between patient, PCP, specialist and hospital. Recruits providers and negotiates terms of value based contracts, facilitates relationships between key stakeholders, and creating medical neighborhoods that facilitate optimal patient care and communication.
  • Active participation in best practice development and sharing, team activities, and administrative functions.

Qualifications

Education Level: Master's Degree in Public Health, Health Administration, Business Administration, or related field OR in lieu of a Master's degree, an additional 6 years of relevant work experience is required in addition to the required work experience.

Experience: 2 years health care experience.

Preferred Qualifications

  • Proven Experience in managing government programs such as Medicare or Medicaid.
  • In-Depth knowledge of Medicare and Medicaid regulations, policies and procedures.
  • Consulting skills and/or direct experience in a consulting role.
  • Experience in a clinical setting or knowledge in a clinically related field.
  • Project management experience.
  • Experience using Client Relationship Management (CRM) System(s).

Knowledge, Skills And Abilities (KSAs)

  • Demonstrated ability to effectively comprehend complex data analysis.
  • Solution development.
  • Executive presentation skills.
  • Effective written and interpersonal communication skills.
  • Effective at building relationships with various levels of business professionals and/or clinicians.

Salary Range: $67,104 - $133,276

Travel Requirements

Estimate Amount: 80% Able to travel through assigned region on a daily basis and work in the field the majority of work days

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Department

Practice Transformation Care

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

Physical Demands

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship.

Salary : $67,104 - $133,276

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