Responsibilities

The Clinical Lead reporting into the Corporate Director, Population Health, will participate in the design, documentation and implementation of Clinical and / or Quality aspects of the population health model to new 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
• Assist in developing and implementing new programs that align with the department’s goals and objectives
• Assist in creating and maintaining departmental policies.
• Research 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.
• Manage, plan and monitor aspects of the program / project of an initiative

Education / Experience :

• Bachelor’s Degree (Business of Healthcare) or equivalent work related experience.
• RN / LSW preferred. RN BA is preferred or equivalent. 5 years working at a payor / MCO. For LSW, Master’s degree preferred or equivalent 5 years working at a payor / MCO.
• 5 years of progressive experience in a managed care environment. Experience with Managed Medicaid programs highly desirable.
• 5 years experience in healthcare environment, health insurance payor environment or related industry.
• 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 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
• Experience in writing policies, workflows, job aids.
• Ability to work effectively under tight deadlines.
• Understanding Population Health strategy
• Project Management capabilities
• Knowledge of work flows preferred

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.

Employer-matched 401(k) and additional non-elective contributions, starting on day one.

Medical, dental, and vision plans with coverage starting on day one.

Employee assistance programs, fitness reimbursements, nutrition counseling, and more.

Employer paid life insurance, with opportunities to purchase additional coverage.

Employer paid short-term disability coverage and long-term disability coverage.

Tuition assistance, including reduced tuition at certain schools.

Financial assistance with adoption, including paid time off.

Flexible spending and health savings accounts to pay for qualified expenses.

Discount programs on entertainment, travel, and more.

Last updated : 2024-04-23