Clinical Manager, Population Health

The Manager of Population Health and Strategic Partnerships develops and maintains an ongoing collaborative relationship with partners, based on mutual respect, high-quality outcomes, and patient satisfaction. This position works to continually shape the network landscape, successfully navigate a variety of stakeholders’ visions, including health systems and community-based organizations. Success in this role requires strong diplomacy skills and a passion to establish deep connections and insight into success factors of network collaboration. This vital role acts as liaison, bringing partners together with Well Care to ensure consistent, efficient delivery of services resulting in positive outcomes for patients and facilitates achievement of key performance indicators (KPI). Manager of Population Health and Strategic Partnerships also owns analyzing and delivering necessary KPI reporting internally and externally; working with other clinical leaders to ensure engagement of clinicians in the use of clinical programs and care pilots to optimize patient experience and outcomes. The role includes assisting with development, and implementation of new evidenced based clinical programs and innovative care models. This position requires critical thinking skills, market-specific strategic mindset, attention to detail, an ability to multi-task in a fast-paced environment and an understanding of various healthcare settings and payment initiatives. This team member must be a proactive and process driven individual, eager to grow, manage a team, and be willing to dive in, or when appropriate, manage through influence.

PRIMARY JOB DUTIES

Population health team/innovative care pilots/evidenced-based clinical programs

• Manage performance, scalability, and growth of population health teams (Telehealth and Navigation) and personnel needs. Responsible for ensuring that team members receive appropriate supervision and professional development.
• Provides day to day direction to population teams to meet key performance initiatives while identifying cost reduction strategies and increased efficiency, including optimization of EMR.
• Development and oversight of scorecard to deliver key performance indicators (KPI) and goals for population health teams.
• Cultivate a strong internal culture designed around collaboration, feedback, motivation, and accountability.
• Management of clinical programs, innovative care pilots, and readmission initiatives, including but not limited to accountability to optimize usage, and oversight of key performance indicators (KPI) and goals.
• Work collaboratively with other clinical leaders to design, develop and implement new and existing evidenced based clinical programs and innovative care models that improve engagement with strategic partners to support business growth and incorporate all lines of business, focusing on quality and operational efficiencies across the organization.
• Work directly with the Director of Population Health to review performance and develop/refine the strategy to maximize KPI achievement.

Clinically Integrated Network (CIN) and Preferred Partners (PP)

• Develop, grow, and sustain positive working relationships with CIN and PP supporting identification and onboarding of new network partners to build a high-quality network base.
• Ensure expectations and objectives are understood by network partners, and that goals are closely aligned.
• Oversite of Well Care data (KPI) for PP and CIN partners. Deliver performance metrics at a regular cadence internally and to partners.
• Collaborate with Clinical Operations, Clinical Quality and Education teams on plans for ongoing internal quality improvement activities and educational needs to meet partner goals based on CIN and PP expectations and feedback.
• Prepare information for patient case status summaries, success stories, etc. and participate in meetings as needed, both internally and externally.
• Develop partner facing educational and summary documents that promote quality service and collaboration, as needed, supporting new and existing strategic network initiatives, programs.
• Evaluate CIN receptiveness, quality of care and achievement of KPIs measured to benchmarks and goals.
• Hold CIN accountable for professional collaboration, timely delivery of clinical information, and KPIs.
• Report challenges with care and coordination.
• May participate in network narrowing strategies.
• Support data-driven decisions, relying heavily on analytics and outcome reports to drive business.

Measures of Success:

• 60 Day hospitalization rates at or below goal (20%)
• Population Health team readmission rate at or below goal (20%)
• Meet enterprise HH admission goal (20%)
• Internal Admissions at targeted goal (10%)
• HHCAHPS (10%)
• Well Care Way (20%)

JOB SPECIFICATIONS

• Education: Bachelor’s degree required; Master’s preferred
• Clinical licensure – Active, unrestricted Registered Nurse License in North Carolina or South Carolina
• 3 years of management experience required; leading teams remotely is preferred
• Home Health experience required
• Proficient with Microsoft Office applications including Word, Excel, and PowerPoint
• Ability to travel 40%
• All candidates must have the capacity to drive the optimization of programs, analytics, and proactive strategy, and people management
• Experience with Program development and management preferred
• Understanding of various healthcare settings and knowledge of Alternative Payment Models (APM’s) is a plus
• Strong interpersonal skills and demonstrated ability to take leadership on multiple projects requiring collaborative, strategic and analytical thinking.
• Excellent written and verbal communication, professional writing, and presentation skills