• Sr. Manager, Population Health

    Job Locations US-VA-Glen Allen
    Job ID
    2018-4709
  • Overview

    The Sr. Manager of Population Health will support the Director of Population Health in all quality activities related to population wellness, member engagement and outreach. S/he will manage the scheduling and auditing of the Provider Engagement Coordinators. The Sr. Manager of Population Health is responsible for oversight and coordination of all aspects of member engagement to include, but not limited to ensuring coverage for all events in the provider offices, timely collection of medical records after each provider wellness event, which supports the HEDIS year-long data collection process, managing and ensuring all departmental budgets are met. This position will have oversight for all Provider Engagement activities spanning Medicaid, Medicare and LTSS.

     

    The Sr. Manager Population Health will assist leadership in establishing the Population Health and Quality Performance Initiatives related to impacting HEDIS measures and Consumer and Health Plan Survey (CAHPS) ratings. The incumbent will assist in the oversight and management of implementing quality strategies for closing care gaps. This role works closely and collaboratively with various functional areas of the organization to achieve the goals and objectives of the Population Health and Quality Programs. Travel is mandatory.

     

    Responsibilities

    • Manage the Provider Engagement Representatives
    • Manage the completion of the State notification log of events
    • Follows the direction of the Director, Population Health in the implementation of wellness days in provider offices
    • Participates in the Member Advisory and Provider Advisory Meetings as needed
    • Manage collection of medical records after each Wellness Day and make sure records are loaded into the HEDIS administrative database year-long
    • Ensure that mailers are sent at least 30 days prior to the Wellness Day events
    • Manage the accuracy, completeness and notifications to the State (or other entities) of all events
    • Audit each Provider Engagement Rep, at least quarterly, to ensure processes are being followed and member care gap goals are being met
    • Manage training of all new Provider Engagement Coordinators for all regions
    • Ensures that all documentation requirements are met per the guidance of the Director
    • Complies with Plan personnel policies and procedures
    • Develop and maintain the departmental manuals, policies and procedures in accordance with Virginia Premier Health Plan quality improvement guidelines
    • Auditing of Member Incentive Tracker tool, at least monthly, to ensure all members are within state limits for each Line of Business
    • Other duties as assigned
    • Good Driving Record Required

    Qualifications

     

    MINIMUM EDUCATION REQUIREMENTS

    • Bachelor’s Degree required; Advanced degree (Master's with a focus on public and/or population health highly preferred
    • 6 months experience interacting and/or collaborating with physicians in a medical setting

    SPECIAL KNOWLEDGE AND/OR SKILLS

    • Analytical skills – proficient using Microsoft Office including Microsoft Excel
    • Openly and actively communicates information and takes initiative to communicate extensively
    • Ability to handle difficult situations diplomatically
    • Two or more years’ experience in a leadership role or a Master's Degree
    • Effective interpersonal skills, collaboration, and listening skills
    • Ability to build strong relationships within and outside the health plan
    • Strong strategic and business acumen and well grounded in healthcare delivery systems
    • Ability to plan, prioritize and multitask, while maintaining attention to detail
    • Ability to adapt to changing priorities
    • Negotiation skills
    • Must be able to travel
    • Must be flexible
    • Effective group facilitation abilities

    WORK BACKGROUND/EXPERIENCE

    • Previous experience in public or population health, member and.or provder engagement
    • Medicare/Medicaid experience / knowledge highly preferred
    • Six Sigma training preferred or must be completed within the first year of employment

    PHYSICAL REQUIREMENTS

    •  Physical health sufficient to meet the ergonomic standards and demands of the position.

    About Us

     

    Virginia Premier is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs. Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia.

     

    We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

     

    All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

     

    Our mission is to inspire healthy living within the communities we serve!

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