Experience Inc. Jobs

Job Information

AmeriHealth Caritas Vice President Population Health Clinical Operations in Philadelphia, Pennsylvania

Vice President Population Health Clinical Operations

Location: Philadelphia, PA

Primary Job Function: Management

ID**: 20815

Job Brief

The VP, Population Health Clinical Ops is responsible for oversight of policy and execution for all enterprise Population Health objectives regarding integrated care management and building a whole person care approach to serve members.

Your career starts now. We’re looking for the next generation of health care leaders.

At 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 www.amerihealthcaritas.com .

Responsibilities:

The VP, Population Health Clinical Ops will identify opportunities for next best actions to improve health of population and lower costs. This leader will apply expertise in developing and utilizing key performance indicators to identify and investigate complex problems in various health care domains across several problem spaces. This leader will also deliver results on high-impact projects collaborating with various stakeholders.

Major Accountabilities:

  • Oversight of execution of enterprise clinical programs delivered through comprehensive care management for members with chronic conditions and emerging risks.

  • Oversees the development of proactive strategies and defines processes to review and optimize interventions/ initiatives to impact engagement from members and providers.

  • Ensures operational standardization of population health programs across all market.

  • 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.

  • Leads a clinical team of Corporate Directors, Population Health, who will manage the Market Clinical Directors and the Population Health activities across all markets.

  • Ensures compliance with contractual requirements for all Care Management activities.

  • Supports RFP responses and evaluation and vetting of new vendor programs.

Education/Experience:

  • Bachelor’s Degree

  • Registered Nurse with active licensure.

  • Ten or more years of progressive management experience (including staff management) in a managed care environment.

  • Experience with Managed Medicaid programs highly desirable.

  • Operational management experience with Quality programs and Case Management programs.

  • Demonstrable history of success in managing clinical programs in Medicaid and/or Medicare managed care organizations.

  • Strong business acumen.

Note: Presently all our Associates are working remotely. Our current location is 200 Stevens Drive, Philadelphia, PA 19113. We are in the process of building a new headquarters in Newtown Square. That address is 3805 West Chester Pike, Newtown Square, 19073. This role/department will be transitioning there when it is safe to return to the office. Must be commutable distance to both locations and open to full relocation.

EOE Minorities/Females/Protected Veterans/Disabled

DirectEmployers