Director Population Health Operations and Clinical Support

We’re searching for a Director of Population Health Operations and Clinical Support, someone who works well in a fast-paced setting. In this position, you'll develop and oversee a comprehensive population health management strategy to improve the health and wellbeing of STAR Kids and STAR/CHIP members, including social determinants of health. This position will help to define population health initiatives and create a structured, scalable approach to prioritizing and monitoring population health initiatives through appropriate outreach campaigns, health screenings and referral programs

 

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Job Duties & Responsibilities

• Ensures STAR Kids timeliness measures are met for new member outreach and initial SAI timeliness
• Ensures Member complaints are received timely, and all interventions and resolutions are appropriate
• Ensures PDN/LTSS Specialty Care Team works collaboratively with internal and external partners and appropriate care delivery. Reduces avoidable costs of care
• Creates and manages a population health strategy by identifying and addressing specific needs of STAR Kids and STAR/CHIP subpopulations. Integrates population health principles and evidence-based research to develop interventions
• Through call campaigns, develops new and enhance existing interventions to improve HEDIS metrics, clinical outcomes, and reduce cost
• Oversees development of social determinants of health program, including MCO outreach and partnerships with community organizations
• Represents MCO as thought-leader and community partner for SDOH needs and healthy equity
• Collaborates effectively with Executive Leadership and other leaders of the system. Utilizes presentation skills to demonstrate need and propose solutions
• Communicates positively and appropriately to work effectively as a team. Provides appropriate information at the appropriate level and audience 
   

Skills & Requirements

• Bachelor's degree in nursing or social work required
• Master’s degree in nursing preferred
• 5 years of supervisory/formal leadership experience required
• 4 years of progressively responsible professional experience in population health, community public health, ambulatory care, or healthcare administration required 
• Experience with NCQA accreditation process requirements preferred 

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.
Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.