Description

California Annual Salary Range: $78,562 - $121,771

Job Summary

The Quality Department is committed to preventing disease, ensuring patient safety, and eliminating inequities by improving the quality of care members receive through partnerships with providers and community-based organizations. Reporting to the Population Health Manager, this position leads the Population Health team by guiding the development, implementation, and monitoring of population health programs and quality improvement activities to advance health equity.

The Population Health team leads CenCal Health’s identification, prioritization, and implementation of plan-wide initiatives to improve clinical quality and reduce inequities in the communities served.

The Population Health Supervisor's responsibilities include but are not limited to supervising the Population Health team by monitoring and measuring productivity, providing training to staff, resolving staff issues, and identifying areas for improvement. The Population Health Supervisor will work to lead and develop population health programs that align with California Advancing and Innovating Medi-Cal (CalAIM) requirements, including compliance with the National Committee for Quality Assurance Health Plan Accreditation standards.

Duties and Responsibilities

• Supervise Population Health staff, including time off requests, timeliness, and resolving daily issues/concerns.

• Ensure staff success by coordinating staff assignments and coverage to assist them in meeting expected and desired goals. This includes ongoing training and mentoring of both new and experienced team members.

• In collaboration with management, perform annual reviews and necessary disciplinary actions.

• Continuous collaboration with CenCal Health's internal and external stakeholders to support the development and implementation of population health programs and quality improvement/health equity interventions.

• Recommend strategies to maximize the effectiveness and efficiency of CenCal Health's ability to address social indicators of health, health disparities, and quality improvement processes.

• Recommend strategies to improve operational systems to maximize the effectiveness of CenCal Health's population health programs.

• Oversight:

  • Population Health Programs are required to improve select aspects of care and/or prevent negative outcomes due to disparities in care, including submitting formal program development documentation to applicable regulators.

  • Performance Improvement Projects (PIPs) are required to document Plan resource commitment and activities to improve select aspects of care, including the submission of formal PIPs to applicable regulators.

  • Plan, Do, Study, Act (PDSA) cycles are required to document CenCal Health's activities to improve select aspects of care, including the submission of formal PDSAs to applicable regulators.

  • Year-round clinical improvement activities, including planning, implementation, and coordination of timely and recurring interventions and programs.

  • Analytical reports used for quality improvement and population health surveillance.

  • Quality Improvement and Health Equity Transformation Program work documents

  • Value-based pay-for-performance program (Quality Care Incentive Program) including but not limited to oversight of website updates, Primary Care Provider (PCP) collaboratives, measure updates, and data validation.

• Develop and facilitate training for interdepartmental staff and provider networks on population health programs.

• Participate in internal and external audits as necessary.

• Serve on various staff committees, teams, and workgroups as appropriate.

• Other duties as assigned.

Qualifications

Knowledge/Skills/Abilities

Required:

• Knowledge of population health program theory, development, and practices

• Knowledge of quality improvement theory, strategy, and practical methods to achieve rapid-cycle improvement

• Ability to effectively lead in a cross-functional team environment

• Ability to motivate superior team performance and contribute to building a strong team dynamic

• Ability to establish and maintain positive professional working relationships, both within and outside CenCal Health

• Ability to perform effectively under pressure and maintain focus on daily responsibilities for long-term projects

• Ability to efficiently and effectively manage time to prioritize responsibilities to meet the needs of internal and external stakeholders as well as to meet project deadlines

• Ability to creatively approach systems development and improvement while managing multiple priorities

• Ability to evaluate data, establish facts, and draw valid conclusions

• Self-motivated to seek knowledge to improve personal and professional performance

• Effective oral and written communication skills

• Proficiency in Microsoft Word, Excel, Outlook, and PowerPoint

Desired

• Knowledge of public health, the healthcare industry, Medi-Cal/Medicaid managed care and HIPAA requirements

• Knowledge of State and Local social service agencies and community-based organizations

• Knowledge of NCQA Accreditation Standards

• Knowledge of NCQA HEDIS Technical Specifications and medical record review

• Bilingual in Spanish

Education and Experience

Required:

• Bachelor's Degree in a job-related field

• Three years experience in population health or quality improvement setting, or a combination of academic, professional, or work experience

• Three years of work experience in a lead or supervisory capacity

Desired:

• A graduate degree in a healthcare- or management-related discipline (e.g., MBA, MPH)

• Experience in Medicare or Medicaid/Medi-Cal managed care

• Experience collaborating with community-based organizations

• Experience with regulatory audits (e.g., DHCS, NCQA)

• Experience with electronic medical records systems