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Population Health Manager

Company: CenCal Health
Location: Santa Barbara
Posted on: November 22, 2022

Job Description:

Company DescriptionLooking for a career that makes a difference in people's lives? CenCal Health is a locally-run, not-for-profit health plan that serves nearly 180,000 people, with offices in both Santa Barbara and San Luis Obispo Counties. For 35 years we've been improving the health and well-being of our neighbors through partnership and collaboration, and we're looking for exceptional, mission-driven professionals to help us grow. We are an employer of choice in Santa Barbara, offering competitive salaries, generous vacation & holidays, comprehensive health/dental/vision benefits including a CalPERS pension plan and 457 deferred income plan, a wellness program, a gym in our headquarters and even parking lot BBQs. Come join our group of nice people doing good work at a great company. For more information on who we are and what we do, please visit our website at www.cencalhealth.orgJob DescriptionAt the direction of the Director of Quality, the Population Health Manager is responsible for the daily operations and functions of population health, clinical quality, and health promotion, including personnel oversight and mentorship. In coordination and collaboration with the Director of Quality, support the execution and implementation of a Population Health and Quality Strategy to achieve health equity. The position has direct oversight of the Clinical Quality, Population Health, and Health Promotion teams, and is responsible for organizing, motivating, leading and coordinating team members.The Population Health team leads CenCal Health's identification, prioritization, and implementation of plan wide initiatives to improve clinical quality and reduce inequities for the communities served. The Population Health Manager manages and oversees the daily operations of all functions vital to successfully coordinate, collaborate, and implement operational improvements to systematically and continually improve quality of care. The Population Health Manager assures CenCal Health's Quality Program elements are documented and implemented using industry-standard performance improvement methods to identify barriers, including but not limited to social determinants of health, and design and implement sound interventions to improve care delivery systems.The Clinical Quality team leads CenCal Health's provider-facing outreach to initiate and build strategic partnerships focused on changes in clinical practice that will sustainably improve the clinical delivery of service. The team encompasses clinically-licensed staff. The Population Health Manager manages and oversees the daily operations of all functions to strategically intervene throughout the provider network.The Health Promotion team leads the design, implementation, maintenance, and evaluation of the organization's health education functions essential to maintain regulatory compliance and advance the health status of CenCal Health's membership. The Population Health Manager assures CenCal Health's health promotion program supports the organization's overall quality improvement and population health priorities.Duties and ResponsibilitiesThis position:--- Provide day-to-day management and oversight of Population Health Management and Quality Program to improve population health, mitigate the negative impacts of social determinants of health, and achieve health equity--- In collaboration with Director of Quality, coordinates and implement CenCal Health's Population Health and Health Equity Strategy across departments as needed to ensure compliance with NCQA Accreditation standards--- Implements, maintains, and coordinates the plan wide review, update and continual improvement of CenCal Health's Quality Improvement System, to maximize CenCal Health managed care effectiveness and compliance readiness with respect to applicable DHCS, DMHC, CMS, and NCQA requirements--- Initiates and advances partnerships with contracted providers to increase their adoption and engagement in CenCal Health's strategic initiatives, including but not limited to Pay for Performance programs, to improve quality of care and achieve health equity--- Engages providers in topic-specific Performance Improvement Projects and PDSAs to improve select aspects of care for populations in need of improvement--- Develops and updates written department policies and procedures to ensure compliance with regulatory requirements (e.g. DHCS Contract, NCQA accreditation)--- Supports the annual development of a Population Needs Assessment--- Collaborates with contracted providers and community-based organizations to develop long-term relationships to inspire a shared vision to achieve strategic objectives--- Collaborate with multiple stakeholders to implement evidenced based guidelines, efficient workflows, and strategic initiatives to advance high quality health care delivery.--- Leads, mentors and strategically develops staff expertise; monitors the production and quality standards for assigned teams, including all aspects of performance necessary to assure operational success--- Prepares weekly, monthly, and quarterly reports for internal and external reporting--- Acts on behalf of the Director of Quality as necessary, and other duties as assignedQualifications Skills/Knowledge/Abilities (Indicate Required or Desired)--- Excellent leadership skills, including motivating staff to achieve goals and objectives--- Excellent communication skills, including motivational techniques to invite and elicit feedback, receive feedback with humility, and constantly nurture and build a trusting and high-functioning team--- Knowledge of DHCS Quality System requirements, regulations, and auditor expectations, contract language, principles of negotiation and ability to collaborate cross-departmentally--- Specific and detailed knowledge of NCQA accreditation standards, and strategies for auditor interactions--- Specific and detailed knowledge of population health, social determinants of health, and application of Performance Improvement Project and PDSA improvement methodologies to improve care delivery systems--- Strong communication, interpersonal and teambuilding skills--- Ability to multi-task in a fast-paced environment. Strong time management skills--- Strong analytical and problem solving skills--- Strong project management skills--- Strong customer service experience and orientation--- Proficiency in Excel, Power Point, Word, and web-based functionsCompetencies

  • Management Administration Skills: Manages and/or facilitates employees, budgets and equipment assigned to them, while helping employees maintain a clear picture of their roles and responsibilities to achieve organizational objectives. Helps to develop employee performance by delegating responsibilities and providing accurate feedback and assessments on a timely basis.
  • Leadership Skills: Able to assume a role of formal or informal authority as necessary; advocate new ideas, even when risk is involved; delegate responsibility and empower associates to make decisions; capable of providing constructive feedback to others; able to receive constructive feedback from others; makes personal commitment to mentor and grow others.
  • Strategic Thinking: Formulates objectives and priorities, and implements plans consistent with the long-term interest of the organization in a global environment, Capitalizes on opportunities and manages risks.
  • Communication Skills-Oral, Listening & Written: Communicates both verbally & in writing in such a manner that it is easy to understand and interpret what and why information is being communicated. Listens attentively without interrupting and/or being distracted by other things.
  • Collaboration & Teamwork: Utilizes communication techniques & methods that generate trust, collaboration, open two-way communication and a supportive work environment. Develops and generates team momentum, enthusiasm, and camaraderie to obtain maximum team performance. Values diverse talents of team members and works to include various points of view in decision-making.
  • Human Capital Management:Builds and manages workforce based on organizational goals, budget considerations, and staffing needs. Ensures employees are appropriately recruited, selected, appraised, and rewarded; takes action to address performance problems. Manages a multi-sector workforce and a variety of work situations.
  • Conflict Management:Encourages creative tension and differences of opinions. Anticipates and takes steps to prevent counter-productive confrontations. Manages and resolves conflicts and disagreements in a constructive manner.
  • Decisiveness: The ability to make difficult decisions in a timely manner.
  • Walk the Talk: Do what you say you are going to do. Be accountable for your actions.--- World Class Mindset: Behaves in an honest, fair, and ethical manner. Shows consistency in words and actions. Models high standards of ethics. Punctual, exhibits professional email etiquette. Adhere to company and department standards. Commitment to excellence.Education and ExperienceRequired:--- Current active, unrestricted California Registered Nurse (RN) and/or Nurse Practitioner (NP) License with a minimum of 2 years experience as a RN or NP--- Bachelor's degree--- Thorough knowledge of Medi-Cal/Medicaid and NCQA standards--- Minimum seven (7) years' experience in a managed care environment or equivalent combination of education/experience--- Minimum three (3) years of supervisory experience in a managed care organization, or a combination of demonstrated supervisory and project management excellence--- Minimum three (3) years of leadership in management of regulatory audits, as a principal liaison to lead auditors--- Thorough knowledge of medical provider systems and managed care quality management operations--- Excellent judgment to plan and efficiently and effectively execute goalsDesired:--- Graduate degree in a job-relevant or health-related discipline (e.g., MPH, MSN, MBA)--- Certified Professional in Healthcare Quality (CPHQ)Essential Functions (Consider sitting, standing, travel, working at computer for long periods of time, lifting etc.)--- Physical requirements needed to perform the essential functions of this job, with or without accommodation:
      • Mobility Requirements: ability to operate a keyboard and sit for long periods; reach, bend, crawl, stoop, lift up to ten (10) lbs.
      • Visual Requirements: ability to read close-up and do close-up work
      • Dexterity Requirements: ability to perform repetitive motion (keyboard); writing (note-taking)
      • Hearing/Talking Requirements: ability to hear normal speech, hear and talk on the telephone
      • Emotional/Psychological Requirements: ability to deal with public contact, in person and Normal office environment. Must be able to sit and work at a computer for long periods of time--- Must be able to travel outside the office and attend meetings during and after regular work hours--- Possess a current, valid driver's license with a clean driving record--- Regular attendance is essential to perform this jobAdditional InformationAll your information will be kept confidential according to EEO guidelines.

Keywords: CenCal Health, Santa Barbara , Population Health Manager, Executive , Santa Barbara, California

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