JOB DESCRIPTION

This position will offer remote work flexibility in Michigan. There will be up to 25% travel associated with this role.

Job Summary

Leads and directs team responsible for health plan population health strategy development and delivery, including state specific initiatives and clinical program design. Drives planning and programs focused on member equity and social determinants of health, including but not limited to food insecurities, housing, employment, and incarceration repatriation. Participates with senior leadership to establish strategic plans and objectives. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Oversees state health plan strategic design, implementation, and evaluation of population health initiatives based on deep understanding of population health principles and state specific needs.
• Sponsors and champions state health plan system-wide initiatives, including cultivating support necessary to achieve desired operational objectives.
• Liaises with state department of Medicaid, Single Pharmacy Benefit Manager (SPBM), and other Medicaid contracted health plans on population health initiatives and develops and implements operational plans that address market opportunities/challenges in alignment with established population health goals.
• Participates in the design of all aspects of population health programs.
• Builds analytics and reporting to support population health programs.
• Develops scorecards, tools, and processes to drive implementation and evaluation of the population health programs.
• Leverages population health knowledge and initiative implementation skills to work effectively with clinical and operational stakeholders to synthesize program information, develop and deploy measurement tools and oversee timelines, budgets, and return on investment (ROI) analysis.
• Leads meetings and committees, directs data analysis and reporting, monitors program performance and looks ahead to mitigate risks.
• Creates culture and linguistic program description following National Committee for Quality Assurance (NCQA) accreditation standards.
• Creates health education programs that support food insecurity, housing, employment, and incarceration repatriation.
• Provides leadership and strategic direction to integrate operational assets to support population health infrastructure needs across the state health plan.
• Partners with clinical quality performance management leadership to develop market-appropriate roadmaps, tools, and playbooks.
• Fosters a culture of data-driven improvement.
• Develops policies, procedures, and guidelines for population health operations programs.
• Evaluates regulatory changes and determine steps needed to implement in programs.
• Identifies business development opportunities to support growth of population health programs.
• Oversees and navigates technology and software applications utilized in the delivery of population health programs.
• Identifies delivery systems utilized in member care for population health.

Required Qualifications

• At least 8 years health care experience, including at least 5 years progressive experience in population health, service coordination, ambulatory care, long-term care, community public health, care coordination, or equivalent combination of relevant education and experience.
• At least 3 years of health care management/leadership experience.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates.
• Development and execution of evidence-based population health management integration programs.
• Experience creating interpretive guidelines and program development.
• Proven ability to set and achieve aggressive program objectives and goals.
• Proven ability to implement an effective monitoring program to include providing constructive criticism and requiring acceptable corrective action plans.
• Health care information systems experience.
• Excellent verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V