Director of Population Health

The Director of Population Health is responsible for overseeing the Quality Consultants and Quality Care Managers. This role oversees the execution and performance of key population health services, including value-based reimbursement (VBR) incentive programs, Hierarchical Condition Category (HCC) coding education and incentive alignment, Health Risk Assessment (HRA) completions, and Remote Patient Monitoring (RPM). The Director will collaborate closely with clinical and operational leaders, provider groups, and payers to drive engagement, compliance, and performance outcomes. The Director of PHM will provide expert advice and consulting to physicians and other medical providers to maximize performance in value-based reimbursement participation. This position is responsible for the resolution of a broad range of administrative, clinical, and business operations associated with strategic provider initiatives. The incumbent is tasked with supporting transformational, provider-focused strategies which are created to improve provider practice-patterns that support optimal health care delivery-model execution and performance. The goal of this position is to support and promote practice transformation initiatives that promote a well-designed patient-centered approach to ensure high quality, efficient, and effective valued-based care at a reduced cost.

Summary of Essential Job Functions:

 Develops and manages projects related to improvements in patient experience of care, population health, and reductions in overall cost.

 Provides oversight to Quality Consultants and Quality Care Managers.

 Coordinates and manages quality improvement programs.

 The incumbent reviews and implements interventions related to these improvement plans.

 Works with front-line clinical staff to map care team processes and workflow improvements.

 Analyzes moderately complex clinical data, business processes and interfaces to support provider practices to align with NCQA Patient Centered Medical Home (PCMH) model and the triple aim approach to care.

 Analyzes VBR data output for data verification and integrity. Communicates and resolves data errors on behalf of the provider practice.

 Serves as the operational interface to all engaged payors on behalf of the provider practice. The incumbent works to facilitate practice transformation, education and process improvement.

 Uses advanced business and clinical training experience to research and develop provider tools, protocols and implement resources that can be used to achieve a high-level performance transformation activity.

 Oversee implementation and performance monitoring of HCC coding education, audit, and incentive programs.

 Lead efforts to increase Health Risk Assessment completion rates and optimize workflow integration.

 Direct and expand Remote Patient Monitoring initiatives to support chronic care management and reduce acute utilization.

 Collaborate with providers to align care delivery models with payer incentive program requirements and clinical best practices.

 Build strong relationships with provider partners to ensure adoption and sustained participation in VBR and population health initiatives.

 Deliver provider-facing education and support tools for documentation improvement and incentive tracking.

 Develop training materials, manuals and provider training curriculum. The incumbent conducts presentations to staff, providers and members of committees and other departments to enhance the quality care of the practice. The incumbent participates in the monthly analysis of practice

success and the development and distribution of materials related to same.

 Supports, coordinates and manages all quality care management initiatives.

 Other duties as assigned or requested.

Minimum Requirements:

 Bachelor’s Degree in a clinical health related field. Master’s Degree preferred.

 5-10 years’ experience in Health Care, Quality, IT or related fields.

 Familiarity with current applicable laws and regulations, including federal, state, and non-federal regulations surrounding health care, including HIPAA, HITECH, ACA and other regulations.

 Strong verbal and written interpersonal skills as well as presentation and teamwork skills.

 Strong analytical skills.

 Excellent time management and organizational skills.

 Intermediate to advanced ability to utilize multiple software applications, including but not limited to: MS Excel, Word, Access, PowerPoint and various EHR systems.

 Experience in medical billing, electronic health records or practice management technology is desired

Job Type: Full-time

Pay: $90,222.12 - $108,654.59 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance
• Work from home

Work Location: Hybrid remote in Canonsburg, PA 15317

Salary : $90,222 - $108,655