• Corporate Director, Population Health Clinical Operations

    AmeriHealth CaritasPhiladelphia, PA 19133

    Job #1371833378

  • Corporate Director, Population Health Clinical OperationsLocation: Philadelphia, PAPrimary Job Function: Medical ManagementID: 19441Your career starts now. We're looking for the next generation of health care ~~~ AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at ~~~ .The Corporate Director, Population Health Clinical Operations is responsible for the oversight and execution of population health strategies regarding integrated care management at the lines of business (LOBs). The incumbent will be responsible for the oversight of multiple care management teams across the enterprise and ensuring a focus that account for members with physical health and behavioral health needs, while incorporating social determinants health and addressing health disparities.Responsibilities:+ Assures compliance with all contractual, regulatory and accreditation requirements within the LOBs.+ Execution of enterprise programs delivered through comprehensive care management for members with chronic conditions and emerging risks, to include maternity programs and programs supporting members with special health care needs.+ Assures consistency of care management program execution across all LOBs.+ Monitors performance metrics across LOBs and assures that appropriate action is taken to address performance opportunities consistent with enterprise policies.+ Maintains consistent program implementation and staffing across all LOBs.+ Oversight of care management programs and ensuring value and achievement of ROI.+ Provides subject matter expertise for existing and new business opportunities for the enterprise.+ Collaborates with various cross functional teams to achieve organization goals on Population Health.Education/ Experience:**+ Bachelor's degree required in Nursing or healthcare related field / Master's preferred or equivalent work related experience.+ Clinical license is required, Registered nurse or Licensed Clinical Social worker. BH equivalent or advanced licensure can be considered.+ Progressive Management experience (including staff management) in a managed care environment.+ Experience with Managed Medicaid clinical programs highly desirable.+ Experience in population health program design, implementation preferred.+ Demonstrable history of success in managing clinical programs in Medicaid and/or Medicare managed care organizations.EOE Minorities/Females/Protected Veterans/Disabled