Director-Population Health & Care Management Strategy (Full-Time, Remote/Hybrid, North Carolina Based)

The Director, Population Health and Care Management Strategy is a key role in evaluating member outcomes and initiating population health interventions intended for Alliance Health beneficiaries. 

The Director is pivotal in the development, stabilization, and strategy for Care Management programs. This includes evaluation and optimization of current activities and interventions resulting in proposals for the development of expanded CM programs to support positive member outcomes. The Director will facilitate a seamless approach to population health for the organization.

This position will be primarily remote.  The selected candidate must be a NC resident and be willing to work onsite out of the Alliance Home Office (Morrisville, North Carolina) as needed. Additionally, travel may be required within NC based on business needs and community-based partnership events.  

Responsibilities & Duties

Data Analysis and Reporting

• Work with internal and external data science resources to identify and document data requirements, ensuring population health, member outcome, and program outcome data is captured
• Analyze and interpret data into clear priorities, interventions, and business operations
• Translate and articulate data-driven insights into easy-to-understand communication, appropriate for the intended audience
• Develop reports and presentations to articulate data findings and recommendations

Program and Member Outcome Evaluation

• Applies Care Management Standards of Practice, inclusive of Integrated Care Management Standards of Practice into care management program evaluations
• Identify and analyze data regarding member outcome impacts of Care Management programs
• Analyze and communicate member outcome trends and patters
• Facilitate collaboration with Care Management and Clinical Leadership to identify factors influencing care management impact on member outcomes
• Document identified strengths, barriers, and process improvement needs to drive positive member outcomes
• In collaboration with SVP Pop Health-CM and Sr. Director, develop program evaluation report with recommended strategy and interventions

Population Health

• Remains current with and applies Population Health research, best practices, and industry evolution to population evaluation and program strategy
• Align Population Health strategy to with NC Medicaid Managed Care Quality Strategy. Internal collaboration to ensure Alliance QM Strategy reflects needs identified through population health evaluation
• Collaborate with Director Community Health & Social Impact to ensure that population health findings on member non-health related unmet needs are incorporated into Community Health strategy
• Collaborate with Director Health Equity to ensure Population Health is approached through the lens of health equity and that population health evaluation findings on member trends are incorporated into Health Equity strategy
• Analyze and communicate member outcome trends and patters
• In collaboration with Sr. Director, develop organizational Population Health Strategy

Internal and External Stakeholder Collaboration

• Coordination of multidisciplinary teams and committees
• Work collaboratively with a cross-functional team of internal partners to include, not limited to, care management and clinical leadership, provider network, and medical economics
• Build rapport, trust, and effective working relationships with external partners to include, not limited to, DHHS, state and county partners, and NC SHIP Community Council
• Participate in-person and virtually at internal and external meetings across NC catchment areas

Program Strategy, Policy, and Operational Procedure

• Working with internal SMEs, develop strategy to for program implementation and improvement to include, not limited to, State and Federal Contracts and Requirements, and NCQA Accreditation Standards
• Apply population and member outcome findings to departmental and organizational strategies
• Collaboration with product management to maximize utilization of full functionality of Population Health and Care Management Platform, Jiva, to support strategy, staff efficiencies, monitoring of member health status, and interventions to drive positive member outcomes
• Assist in developing, revising, and maintaining program descriptions, policies, and operational procedures

People Leader

• In collaboration with cross-departmental leadership, strategize and lead change management efforts. Influence across leadership levels and direct member support roles for investment and sustainability of change
• Provide direct supervision of team members. This may inc