Director of Population Health

Scheduled Weekly Hours: 40 - The Director of Population Health is responsible for the overall direction, coordination and implementation of the Quality Program for the Sturdy Health Medical Group. This will include the development and implementation of strategies to enhance patient care, improve population health outcomes and ensure quality and regulatory compliance. The role will be responsible for establishing, deploying and sustaining standard work for all outpatient clinical support roles. The senior director will work collaboratively with clinical and administrative leaders to drive performance improvement and achieve strategic goals. Reports to: Chief Medical Officer; with a dotted line to EVP & COO Manages : Population Health Program Manager, Specialists & Associates Education/Training Nursing degree, Pharmacy degree or Master’s in Public Health or other related field. Licenses/Certification: MSN, RN or PharmD required Board Certified Critical Care Pharmacist (BCCCP) preferred Board Certified pharmacotherapy specialist (BCPS) preferred Required Qualifications and Skills: Minimum of 3-5 years of experience in healthcare leadership experience with significant experience in population health, care management, value-based care, or related areas. Must demonstrate integrity, sound judgment, demonstrated leadership skills, and strong interpersonal skills.  Experience working with quality metrics, healthcare analytics, utilization management and performance improvement. Understanding value-based reimbursement models and payer-provider relationships. Must be able to approach staff about quality issues with tact and diplomacy. Experience working with disadvantaged populations is helpful, and knowledge of health disparities is highly desired. Excellent oral and written communication skills needed; strong organizational ability required. Outstanding skills in data collection, analysis, and presentation. Experience in the use of spreadsheets. Essential Job Functions: Practical knowledge of tools and techniques of continuous quality improvement, including analysis and interpretation of data using computer-based disease registries or similar data collection systems is essential. Assists in the development, monitoring, and presentation of internal quality measures and initiatives. Coordinating tracking and reporting of clinical outcomes, and follow-up of improvement action plans Responsible for developing methods for data collection and extracts data as required Assists with coordination of monthly meetings Prepares quality reports and statistics Participates in staff and management meetings as they relate to quality and population health activities Provides in-service training to non-provider staff in the area of quality improvement Reviews tools and surveys and provides technical assistance to staff Attends conferences and training sessions as requested Quality/Value Based Care and Performance Support the design, implementation, and management of programs associated with Medicare Advantage, ACOs, Medicaid, commercial value-based contracts, and other alternative payment models Monitor quality, utilization, cost, and financial performance associated with value-based arrangements. Identify opportunities to improve performance on quality measures, shared savings, total cost of care, and other contractual metrics. Collaborate with finance, contracting, payer relations, and clinical leadership to translate contract requirements into operational strategies. Develop interventions to reduce avoidable emergency department visits, hospitalizations, readmissions, and other high-cost utilization. Deploy and monitor a MIPS strategy Clinical Operations Direct the development and evaluation of population health programs addressing chronic conditions such as diabetes, cardiovascular disease, COPD, hypertension, and other priority conditions. Oversee initiatives related to preventive care, care gap closure, medication management, transitions of care, complex care management, and disease management. Partner with clinical leaders to integrate evidence-based population health interventions into routine workflows. Oversee maintenance and growth of ambulatory clinical pharmacy services Subcapitation clinical operations Social work & care coordination Operationalize and maintain remote patient monitoring (CGM), (CHF, HTN) to assist with meeting population health/value-based care goals. Clinical pathways for primary care (including pharmacy) and select specialty areas (cardiology, OR) Implementation of care teams and standard work associated to team based care Population Health Develop and execute a system-wide population health strategy aligned with the organization's mission, strategic priorities, community health needs, and value-based care objectives. Lead population health initiatives across the system. Establish annual population health goals, priorities, performance targets, and implementation plans. Partner with executive and physician leadership to establish accountability for population health outcomes across the organization. Develop scalable models for managing high-risk, rising-risk, and complex patient populations. Promote an organizational culture focused on prevention, health equity, patient-centered care, and measurable outcomes. Healthcare Equity Integrate health equity principles into population health strategy, program design, measurement, and resource allocation. Use demographic, geographic, clinical, and social data to identify disparities in outcomes and access. Develop interventions to address social drivers of health, including food insecurity, housing instability, transportation, economic insecurity, and access to behavioral health services. Partner with community-based organizations, public health agencies, schools, social service organizations, and other community stakeholders to im