Director of Population Health

I. Job Summary

The Director of Population Health provides strategic leadership for all population health initiatives across HCHC’s clinical sites. This position is responsible for care management, referral coordination, medical records oversight, risk stratification, and value-based care programs that improve patient outcomes and close care gaps. The Director supervises the Clinical Manager (Care Management) and related teams and ensures compliance with quality standards, HEDIS/UDS reporting, and payer requirements. Working in close collaboration with the Medical Director and Operation Director, the Population Health Director leads the implementation of the Equity and Practice Transformation (EPT) Payment Program, Empanelment Project, and other quality initiatives to integrate population health strategies with clinical practice and operational workflows.

II. Role and Responsibilities

A. Leadership & Supervision

• Provide executive oversight for care management, referral management, and medical records operations across all HCHC sites.
• Supervise and coach the Clinical Manager (Care Management) and ensure effective performance of the Case Management Supervisor, Referral Team, and Medical Records staff.
• Promote professional development, performance evaluation, and succession planning within population health and care management teams.

B. Population Health Strategy & Quality

• Lead the design and execution of population health programs, including chronic disease management, risk stratification, and care gap closure.
• Oversee HEDIS, UDS, and other quality metrics; ensure timely data submission and implement improvement plans.
• Utilize population health tools (e.g., i2i, Cozeva, Manifest, ECW) for proactive patient outreach and real-time care gap alerts.
• Collaborate with payers, IPA networks, and health plans on value-based care and incentive programs.

C. Care Management & Referral Oversight

• Ensure standardized, timely, and documented referral workflows, including hospital discharge follow-up.
• Oversee case management activities such as complex care planning, chronic disease self-management goals, and follow-up on high-risk patients.
• Supervise medical records management to maintain compliance with privacy regulations and ensure accurate, accessible documentation.
• Monitor referral volume trends, bubble balance, and team productivity; implement process improvements to enhance efficiency and patient experience.

D. EPT Payment Program & Empanelment Project

• Serve as organizational lead for the Equity and Practice Transformation (EPT) Payment Program, including program design, reporting, and integration of equity-focused practice transformation goals.
• Lead the Empanelment Project, developing policies and ensuring compliance with organizational and payer requirements.
• Coordinate with IT, QI/QA, Medical Director, and Operation Director to align data, workflows, and provider panel assignments.
• Monitor KPIs such as time-to-next-available appointment and panel capacity to optimize patient-provider assignments and equity objectives.

E. Collaboration & Integration

• Partner with the Medical Director to translate quality data into clinical practice improvements and provider engagement strategies.
• Work with the Operation Director to integrate care management, EPT activities, and empanelment workflows into site operations.
• Serve as liaison to internal stakeholders such as QI/QA Department, and external stakeholders, including IPAs, health plans, and community partners, to strengthen population health initiatives.

F. Compliance, Data, and Reporting

• Monitor and analyze data trends for patient outcomes, risk adjustment, and program performance.
• Ensure compliance with all federal, state, HRSA, and payer regulations for population health and care management services.
• Lead preparation for internal and external audits related to care management, referrals, EPT, and quality reporting.

G. Other Duties

• Provide strategic input to executive leadership on budget planning and resource allocation for population health and care management initiatives.
• Mentor emerging leaders and support cross-training within the population health team.
• Perform other duties as assigned by the COO or executive leadership.

III. Organization Expectation

• Adhere to all HCHC’s Policies and Procedures.
• Upholds HCHC’s mission and core values.
• Maintains professional and collaborative relationships with staff, patients, and external partners.
• Maintains flexibility to support clinic needs, including evenings or weekends.

IV. Education/License/Certification:

• Bachelor’s degree in Nursing, Healthcare Administration, Public Health, or related field required; Master’s degree preferred.
• Active RN or other clinical license strongly preferred.
• Certification in case management, quality improvement, or population health desirable.
• BLS certification required.

V. Skills and Specifications

• Minimum 5 years of leadership experience in population health, care management, or quality improvement within a healthcare setting.
• Strong knowledge of managed care, value-based payment models, and risk adjustment.
• Proficiency in EHR (ECW) and population health platforms (i2i, Cozeva, Manifest).
• Excellent leadership, communication, and analytical skills.
• Bilingual (English and Cantonese/Mandarin/Vietnamese/Spanish) preferred.

VI. Physical Requirement

• Occasional lifting up to 25 pounds.
• Extended periods of sitting, walking, or standing.
• Travel to HCHC clinical sites and external meetings as needed.

Job Type: Full-time

Pay: $55.00 - $65.00 per hour

Expected hours: 40 per week

Work Location: In person

Salary : $55 - $65