Population Health Specialist Jobs

Salary Range: $60,592 - $90,889

Job Summary

The Quality Department is committed to preventing disease, ensuring patient safety, and eliminating inequities by improving the quality of care received by members through partnerships with providers and community-based organizations. The Population Health Specialist will support the year-round design, implementation, and maintenance of innovative improvement interventions and population health programs. Your work will help maximize the quality of identified clinical priorities and address membership needs to advance health equity. You will also support comprehensive health status improvements and provide access to services, education, and wellness support, while reinforcing the importance of preventive health.

Duties and Responsibilities

• Year-round execution of clinical improvement and population health activities, including planning, implementation, and coordination of timely and recurring interventions and programs
• Contributing to the identification of best practices and integration of high quality program ideas/designs to drive improvement
• Developing and facilitating training staff and partners population health and quality improvement initiatives

• Supporting design and development improvements to the following aspects of care:

  • Performance Improvement Projects (PIPs) including the submission of formal PIPs to regulators

  • Plan, Do, Study, Act (PDSA) cycles including the submission of formal PDSAs to regulators

  • Population health programs to reduce and/or prevent negative outcomes due to inequities in care, including the submission of formal program development documentation to regulators

• Performing systematic data collection, analysis and outreach as needed
• Coordinating, editing, and analyzing reports used for quality improvement and population health surveillance
• Population health programs to reduce and/or prevent negative outcomes due to inequities in care, including the submission of formal program development documentation to regulators
• Serve on various staff committees, teams, and workgroups as appropriate
• Recommending strategies to maximize effectiveness and efficiency of operational systems that support quality and population health functions.
• Strategically monitoring and maintaining CenCal Healths incentive programs
• Continuous collaboration with CenCal Healths internal and external stakeholders, to support and maintain compliance with National Committee for Quality Assurance (NCQA) Accreditation Standards for Population Health Management, Quality, and Health Equity as appropriate
• Plan, Do, Study, Act (PDSA) cycles including the submission of formal PDSAs to regulators
• Performance Improvement Projects (PIPs) including the submission of formal PIPs to regulators
• Supporting and maintaining CenCal Healths pay-for-performance program including but not limited to validation of payouts, outreach to program participants to drive improvement, and reference guide updates.

Skills/Knowledge/Abilities

Required:

• Ability to perform effectively under pressure, maintain focus on responsibilities, and manage competing priorities
• Must be a team player and contribute to building a strong team dynamic
• Adherence to HIPAA requirements and confidentiality of all data
• Ability to draft reports including but not limited to provider bulletin articles and committee reports
• Knowledge of quality improvement theory, strategy, and practical methods to achieve rapid-cycle improvement
• Knowledge of population health program theory, development, and practices
• Proficiency in Microsoft Word, Excel, and PowerPoint
• Outstanding interpersonal, service excellence behavior and customer service skills required
• Ability to evaluate data, establish facts, and draw valid conclusions
• Ability to establish and maintain positive professional working relationships
• Effective oral and written communication and presentation skills

Desired:

• Knowledge of NCQA Accreditation Standards for Quality, Population Health, and Health Equity
• Knowledge of Medi-Cal/Medicaid or Medicare managed care
• Knowledge of NCQA HEDIS Technical Specifications and medical record requirements
• Bilingual in Spanish

Education and Experience

Required:

• Two (2) years work experience in a healthcare setting with an emphasis in quality improvement or population health setting, or a combination of academic, professional, or work experience
• Bachelors Degree in a job-related field

Desired:

• Experience with electronic medical records systems
• Experience collaborating with community-based organizations
• Experience with regulatory audits (e.g., Department of Health Care Services, NCQA)