Population Health Advisor

Location: Remote, United States

Primary Job Function: Medical Management

ID**: 34152

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

The Clinical Advisor reporting into the Director, Population Health Programs Excellence, will participate in the clinical thought leadership to create evidence-based clinical program design, development, implementation, and measurement across all lines of business and markets.

• Serve as a resource to departmental leadership for strategic initiatives, special assignments and projects, and preparing related documentation and status updates, as requested by leadership

• Research literature, clinical models and prepare materials related to department programs for Departmental leadership. This may include, assisting in the completion a systematic review of evidence used to help guide leadership and department in developing new programs.

• Develop and manage detailed design on multiple programs across at least 11 Medicaid markets and 5 Medicare markets, including customization for specific contract requirements.

• Create and implement technology and reporting business requirements documents that meet the objectives of the project on time and within budget.

• Create and implement detailed policy, process, and/ or job aide documents to support new programs and reporting. Work with training team to implement new processes for approximately 1400 FTEs.

• Work with Population Health Program Excellence and Population Health leadership to standardize processes, create efficiencies, and improve effectiveness across markets where possible.

• Manage, plan and monitor aspects of the program/project of an initiative, including liaising with enterprise analytics for program measurement outcomes, under the guidance of the Director of Clinical Program Strategy and VP of Population Health Program Excellence.

• Create remediation plans when needed to improve program outcomes.

• Work closely with growth team to incorporate outcomes into upcoming Requests for Proposals or other growth initiatives

Education/Experience:

• Bachelor’s Degree (Business or Healthcare) or equivalent work experience

• 10 or more years of experience in a healthcare environment, health insurance payor environment or related industry

• 5 or more years of progressive experience in a managed care environment. Experience with Managed Medicaid programs highly desirable

• Understanding of Population Health strategies

• Project Management experience

• Strong organizational and motivational skills to manage multiple projects, issues and priorities

• Proven ability to think critically, as well as creatively, while managing complex projects and driving business deliverables to meet timelines

• Excellent collaboration skills to co-design with multiple constituents in a matrix environment while upholding the evidence-based design

• Excellent written and oral communications skills including the ability to produce executive summaries

• Advanced knowledge in the use of web-based technology and Microsoft Office applications such as Word, Excel, Visio and Power Point

• Ability to build, promote and maintain strong collegial relationships

• Proven team work/building and networking skills

• Knowledge and/or experience with NCQA accreditation products, especially CM, PHP and CM-LTSS, will be helpful

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

EOE Minorities/Females/Protected Veterans/Disabled