Population Health Resume Samples

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VE
V Effertz
Vanessa
Effertz
222 Jacquelyn Mission
Houston
TX
+1 (555) 815 1398
222 Jacquelyn Mission
Houston
TX
Phone
p +1 (555) 815 1398
Experience Experience
Detroit, MI
Population Health Analyst
Detroit, MI
Green, Skiles and Crona
Detroit, MI
Population Health Analyst
  • Maternal Care Quality Improvement: Supports efforts to improve maternal and infant health outcomes in Michigan Medicaid through CMS Maternity Core Set measure reporting, support of the MIHP program integration with Medicaid managed care, assisting on grant-related activities for the CMCS grant entitled Improving Maternal and Infant Health Outcomes in Michigan Medicaid through Access to Effective Contraception (including working on the developmental contraception measures), and facilitating efforts related to the Michigan Infant Mortality Reduction Plan
  • Health Equity: Leads the collection and analysis of performance measure data stratified by race/ethnicity and other demographic characteristics to identity health disparities; provides assistance with the implementation of evidence-based strategies to reduce identified gaps in care
  • Population Health Management: Supports the implementation of population health management strategies as outlined in the Michigan Medicaid Managed Care contract, including the development of processes to collect data and implement new managed care programs related to the social determinants of health
  • Familiarity with Quality Improvement Initiatives such as HEDIS
  • Collaborate with various departments within Sutter such as Finance, Quality, Variation Reduction team, and Business & Planning, etc. as well as EPIC team and PAMFRI to understand organization’s data structure and content, and other initiatives to support and strengthen business process and outcomes analysis for Managed Care
  • Working closely with Executives, Medical Directors, Physicians to identify data points, define metrics, determine analysis, and reporting design for clinical, financial impact and patient outcomes
  • Assists with identifying statistically significant patterns and trends
Boston, MA
Senior Medical Director Population Health Management
Boston, MA
Shields-Hammes
Boston, MA
Senior Medical Director Population Health Management
  • Collaborate with product organization and functional partners to continually seek ways to enhance and quantify the value of existing services and develop new products and solutions to address emerging market opportunities
  • Lead strategy and support the execution of activities that positions CSG as clinical thought leader
  • Develop key messages and talking points for communicating clinical program management to key external stakeholders
  • Continuously seek to identify potential growth opportunities and provide clinical support to CSG in presenting solutions to potential new clients
  • Enhance programs that build trust within the provider community and encourage providers to partner with Optum on clinical initiatives that drive improved consumer outcomes and reduced costs of care
  • Create and maintain strong relationships with key clinical leaders across Optum and UHG
  • Represent CSG on key clinical committees within and outside of Optum
present
Phoenix, AZ
Executive Director of Population Health
Phoenix, AZ
Zulauf-Mitchell
present
Phoenix, AZ
Executive Director of Population Health
present
  • Assist association leadership with establishing a healthy workplace culture that embodies the YMCA mission and our role in the community
  • Develop annual budget and manage your programs so that they operate within established fiscal boundaries
  • Identify and recruit employers and insurance providers to reimburse and/or pay for their employee’s participation in our evidence-based interventions
  • Assist with Annual Support Campaign as assigned
  • Align Population Health sales and development strategies with those of the Marketing and Communications and Membership Departments
  • Work collaboratively with the membership department to ensure member satisfaction, conversion and retention
  • Attend and participate in all meetings, program development activities, YMCA events and healthy living program initiatives
Education Education
Bachelor’s Degree in Health
Bachelor’s Degree in Health
Loyola University Chicago
Bachelor’s Degree in Health
Skills Skills
  • Ability to develop professional and effective working relationships with clients and colleagues
  • Strong computer literacy and the comfort, ability and desire to further advance technically. SQL
  • Excellent client-facing skills with clients and the ability to champion the cause of the client and serve as an athenahealth advocate
  • Serve as client contact, responsible for maintaining excellent relationship with client management
  • Provide training to the client’s analytics team and provider and care management teams when applicable
  • 1-4 years of work experience in a professional environment
  • Proficient in Microsoft Office Suite
  • Proactively works to decrease knowledge gaps with process and functionality
  • Shares process & product knowledge with peers and clients in an organized and clear manner
  • Carries themselves in a professional manner
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15 Population Health resume templates

1

Population Health Medical Director Resume Examples & Samples

  • Establishes strong, positive collaborative relationships with client IPA physicians
  • Provides leadership to enhance management strategies and interventions designed to produce optimal quality outcomes with efficent use of clinical resources
  • Develops and implements strategic initiatives to achieve system goals and objectives
  • Plans and implement continuous improvement initiatives to achieve clinical care that demonstrates an overall standard of high quality clinical outcomes as characterized by best practices and objectively measured against regional and national benchmarks. Build consensus around the appropriate tools and methodologies to achieve this
  • Monitor and remediate when necessary the outcomes of utilization review and effectiveness of clinical programs to meet the quality and cost goals and objectives
2

Population Health Management Director Resume Examples & Samples

  • Experienced clinical background as RN, Nurse Practitioner or Physician Assistant
  • Previous management and clinical operations experience in the managed health care industry leading teams focusing on operational improvement and performance management
  • Ability to apply leadership strength and critical thinking to short-term, mid-range, and long-term goals
  • Strong knowledge of Population Health Management and either Stars/CMS/Quality, HEDIS, Provider Rewards or MRA Coding
  • Executive-level communication skills, written and verbal, that can be applied to external professional and lay audiences as well as internal audiences
  • Experience with program implementation in a state and/or federal regulated environment. High ethical standards and respect for compliance
  • Advanced degree, MBA, MHA, public health or clinical
  • Quality Improvement, Population Health or process improvement experience
3

Population Health Clinical Manager Resume Examples & Samples

  • Bachelor’s Degree in Nursing or another health related field strongly preferred
  • Strong organizational and prioritization skills with ability to collaborate with multiple departments
  • Working knowledge of Population Health Management and either Stars/CMS/Quality, HEDIS, Provider Rewards
  • Previous quality management, utilization management, hospital or physician office practice experience
  • Excellent PC skills (including MS Word, Excel and PowerPoint)
  • Advanced degree, MBA, MHA, public health or clinical degree
  • Three to five years of progressive experience with leading quality teams
4

Population Health Solutions Market Manager Resume Examples & Samples

  • Oversee the set-up of Humana's service fund and Provider file maintenance for Provider groups
  • Manage and deliver reporting and analysis on profitability and performance for internal and external entities on Provider groups
  • Perform and/or collaborate with Finance on analysis of trend issues, cost savings opportunities, utilization patterns, and other analysis as needed on Provider groups
  • Make recommendations to market leadership through detailed analysis/consideration of financial and operational implications to Humana and the groups
  • Serve as focal point for Provider risk group questions regarding financial settlement, delegation, claims adjudication and funding
  • Successfully facilitate & implement various initiatives with groups (HEDIS, MRA, STARS, etc.)
  • Bachelor’s degree in Finance, Accounting or any field
  • Demonstrated management experience and partnering with senior leadership on strategic initiatives
  • Proven planning, preparation and presenting skills, with established knowledge of reimbursement and bonus methodologies
  • Deep understanding of strategic planning, start-up product launching, and research processes
  • Enthusiasm and motivation essential; a confident change-agent; strong selling and presentation skills (oral and written)
  • Willingness to manage and prioritize diverse projects
  • Graduate degree in finance, accounting, or related field
  • Knowledge of Humana’s financial processes, Service Fund, market reporting, etc
  • Proficiency in analyzing and interpreting financial trends for health care costs, administrative expenses and quality/bonus performance
  • Ability to mentor and manage associates in provider loyalty and engagement methodologies
5

Population Health Analyst Resume Examples & Samples

  • Bachelor’s degree or equivalent in Actuarial Science, Computer Science, Mathematics, Statistics, Biostatistics, Epidemiology, Public Health, Biology, Health Sciences or related fields
  • 1-2 years of experience performing health data analytics
  • Excellent PC skills (including MS Word, Access, and Excel)
  • Master’s degree or equivalent in Actuarial Science, Computer Science, Mathematics, Statistics, Biostatistics, Epidemiology, Public Health, Biology, Health Sciences or related fields
6

Population Health Analytics Consultant Resume Examples & Samples

  • Master’s degree or equivalent in Actuarial Science, Computer Science, Mathematics, Statistics, Biostatistics, Epidemiology, Engineering, Public Health, Biology, Biomedical Sciences or related fields
  • Strong organizational and time management skills
  • Prior experience in a healthcare / insurance environment
  • Experience working with Java Scripting
  • Expertise in data mining, forecasting, simulation, and/or predictive modeling
7

Population Health Product Manager Resume Examples & Samples

  • Maintain knowledge of industry trends in Accountable Care Organizations Operations, Population Health Management and Disease Management
  • Understanding of Patient/Member flow across the healthcare and community settings
  • Demonstrates understanding of Transitional Care and Coaching; Public Health and Community Assessment; Ambulatory and Clinic Workflows as well as payment and insurance practices and trends
  • Actively participate in the creative design of new product offerings and features based on current healthcare related trends, business needs or client requests
  • Ability to document clinical and technical requirements analysis for product enhancements
  • Perform demonstrations of product features and workflow as needed
  • Understand client uses of the Midas solutions. Identify best practice system usage and maintain a client reference site listing
  • Explain desired features and functionality to Business Analysts, Developers and Software Architects in order to facilitate development and troubleshoot software
  • Work collaboratively with partner vendors to integrate multiple software solutions into one client experience
  • Interpret regulatory and vendor specifications and define product requirements that deliver solutions to clients that maintain compliance and compatibility
  • Minimum of 3 years’ experience in a healthcare setting
  • Experience in areas of ACO operations, Population Health Management &/or Disease Management
  • Midas Case Management and Community Case Management experience preferred
  • Bachelor’s degree in healthcare related field, preferably RN, Social Work or Public Health
  • Up to 50% travel required
  • Leadership and time management skills
  • Ability to integrate multiple details and complex processes into a clear action plan for self and team members
  • Understanding of data integration principals using various formats such as HL7 and CDA
  • Knowledgeable about web-based application development processes, including experience with Agile
  • Familiar with governmental requirements as related to ACO operations
  • Ability to communicate effectively, both verbally and written, with customers, co-workers and business contacts in a courteous and professional manner
8

Population Health Partner Resume Examples & Samples

  • Recruit, develop, and manage a team of industry consultants
  • Manage the commercial and financial obligations of their practice
  • Identify and develop new consulting offerings and coordinate these offerings with the horizontal technology organizations and the other healthcare delivery organizations
  • Applies industry practice perspective to business models to diagnose capability gaps and conceptualize potential business model alternatives and information technology (IT) implications (Business)
  • Leads client in creating a compelling vision, principles, constraints, assumptions and performance metrics and goals that are associated with current and future state business processes (Business)
  • Provides “strategic advisor” perspective to clients; provides information on current and latest trends and issues in their industry to help pinpoint major opportunities for change (Business)
  • Uses Catalyst phases, activities and tasks as a basis for developing estimates and team plans (Methodology)
  • Leads a team of 6-10 resources (company, client and third-party resources) in area of expertise to conclusion of a project phase (Management)
  • Shares technical trend and best practice knowledge with colleagues and clients (Technical)
  • Manages client expectations and balances the needs of the company and clients to ensure satisfaction for both (Relationship Management)
  • Influences decisions and project direction at the executive level (Relationship Management)
  • Identifies sales leads through established networks (Leverage)
  • Develops proposal strategies and win themes; participates in sales calls (Leverage)
  • Provides leadership and work guidance to less experienced personnel (Leadership)
  • Presents to large sized groups of key decision makers at the executive level; develops and communicates vision and purpose, encourages contribution and support from others. Contributes to proposal orals and division and company-wide events (Communication)
  • Master's degree in business administration or related field preferred
  • Seven or more years of consulting experience with management and operations strategy
  • Five to nine years of additional relevant experience in healthcare delivery and/or healthcare finance
  • Experience working as a healthcare clinician is desirable
  • Three to five years of experience with population health, care management, or alternate care delivery models
  • Strong skills in developing compelling proposals that meet delivery excellence requirements
  • Ability to deal with and resolve ambiguity
  • Ability to anticipate problems and take decisive action, giving regard to the impact on both the client and the company
  • Ability to adjust personal style to different situations
9

Population Health Analytics Consultant Resume Examples & Samples

  • Prior experience in a fast paced insurance or health care setting
  • Computer literate (MS Word, Power Point, Excel). Expert analytical skills, spreadsheet modeling and database development
  • Strong relationship building skills
  • Knowledge of Humana’s internal policies, procedures and systems
10

Population Health Analyst Resume Examples & Samples

  • Bachelor’s degree or equivalent in Actuarial Science, Statistics, Biostatistics, Epidemiology, Public Health, Biology, Health Sciences or related fields
  • Excellent PC skills (including MS Office - Power point, Word, Access, and Excel)
  • Master’s degree or equivalent in Actuarial Science, Statistics, Biostatistics, Epidemiology, Public Health, Biology, Health Sciences or related fields
  • Prior experience in community health / healthcare / insurance environment
11

Data Analyst, Population Health Analytics Resume Examples & Samples

  • Experience performing clinical data analytics
  • Knowledge of statistical methods and tools
  • Familiarity with Quality Improvement Initiatives such as HEDIS
12

Transcend Population Health Market Leader Resume Examples & Samples

  • Develop personal/professional alignment with Transcend’s population health model – including the commitment to a “Provider Partnership” role with a keen focus on data integrity, quality of care and optimal outcomes for Transcend services provided to physician practices
  • Collaborate and partner with health plan Provider Development, Medical Management, Data Analytics, Care Management, Pharmacy, and Medicare Stars/Risk Adjustment functions to identify strategies and evaluate how shared and combined resources can improve physician transition into provider rewards and reimbursement strategies
  • As a key contributor to the success of provider client’s value-based reimbursement programs
  • Facilitate and coordinate Transcends quality, documentation, coding and care coordination resources around each provider client
  • Evaluate trends in performance and opportunities for improvement, determine best practices, and implement action plans to bridge gaps in performance at the market level
13

Population Health Medical Director Resume Examples & Samples

  • Provides leadership to enhance management strategies and interventions designed to produce optimal quality outcomes with efficient use of clinical resources
  • Board Certified MD/DO in an approved ABMS Medical Specialty (Primary Care Provider highly preferred)
  • Current and unrestricted license in at least one jurisdiction and willing to obtain license, as required, for various states in region of assignment
  • Medical staff leadership experience for a large multi-specialty group practice, physician practice management organization, hospital/hospital system, or an MCO (preferably with a physician group practice component)
  • Experience with hospital organized medical staff, managed care organizations, and continuous quality improvement activities
  • Proven track record leading physician groups, including group facilitation, leadership development, team-building, performance management, and driving cultural change
  • Experience working with physicians to strategize and develop measurable improvements the quality of clinical care and patient satisfaction
14

Population Health Solutions Architect Resume Examples & Samples

  • Equivalent to a Bachelor’s Degree in a related field or equivalent combination of relevant education, technical, business and healthcare experience
  • 8 plus years related experience
  • Advanced knowledge and skills in the design and development of data systems
  • Must demonstrate general knowledge of information technology and healthcare
  • Experience in small scale project planning and reporting either individual or team
  • Communication and presentation skills to engage technical and non-technical audiences
  • Requires ability to communicate and interact across facilities and at various levels
  • Able to mentor less experienced team members
  • Able to demonstrate a clear understanding of Medicare, Medicaid, Commercial and other Specialty Healthcare plans
  • Fundamental understanding of the difference between volume and value based accountable care, healthcare models
  • Experience working with Managed Care programs
  • Experience working with Population Health Management platforms
  • Experience working with Payers and Health Information Exchanges
  • Works in collaboration with business and senior leadership teams to identify and establish information requirements, develop and implement enterprise wide data integration strategies that utilize data marts and data warehouse applications to enhance business processes
  • Researches new technology and develops business cases to support health plan wide business solutions
  • Creates detailed documentation on Business plans that address customer, partner, physician and payer needs that are suitably articulated for the corresponding audience
  • Works to fully understand the needed data structure definition that supports both business reporting needs and business analytics processing
  • Transmits data by various means between hospital system entities and proactively works to ensure data quality, troubleshoots data issues, and devises creative and effective ways to avoid or mitigate issues
  • Interacts with a diverse set of customers (i.e., payers, partners, physicians) and speaks to a business non-technical audience
  • Mentors, advises and leads other technical staff to ensure solutions are properly implemented as well as IT leads to support cross-functional IT areas
  • Demonstrates a high level understanding of the data elements and standards typically involved in Health Care transactions and reporting. Is quick to learn, adopt, and apply new standards in a way that satisfies and balances regulatory and compliance requirements with business needs
15

Senior Medical Director Population Health Management Resume Examples & Samples

  • Population Health Management Intervention - the business unit is focused on improving the quality and affordability of health care services provided for acute and chronic health care conditions
  • Provide clinical quality and affordability leadership, in collaboration with product organization, operations, and analytics, through all phases of product development and sales process
  • Responsible for leading strategy of programs designed to optimize quality, affordability and delivery of health care services
  • Collaborate with product organization and functional partners to continually seek ways to enhance and quantify the value of existing services and develop new products and solutions to address emerging market opportunities
  • Work in partnership with operational teams to address variation in quality and affordability using the most efficient and effective process, and to avoid overlapping or redundant approaches
  • Provide oversight to ensure all clinical and reimbursement policies are informed by the best available EBM that improves quality and affordability
  • Lead strategy and support the execution of activities that positions CSG as clinical thought leader
  • Develop key messages and talking points for communicating clinical program management to key external stakeholders
  • Continuously seek to identify potential growth opportunities and provide clinical support to CSG in presenting solutions to potential new clients
  • Collaborate with all internal partners to socialize consumer and provider NPS data and drive actions that create a better consumer and provider experience and improvement in our Net Promoter Scores (NPS)
  • In partnership with other provider experience Optum partners, develop provider segmentation models that determine the best mode of provider interaction/engagement and ease of experience
  • Enhance programs that build trust within the provider community and encourage providers to partner with Optum on clinical initiatives that drive improved consumer outcomes and reduced costs of care
  • Improve the ability of our programs to deliver actionable, real-time data into the hands of our providers
  • Create and maintain strong relationships with key clinical leaders across Optum and UHG
  • Represent CSG on key clinical committees within and outside of Optum
  • Support the business in identifying market trends that should influence key investments (i.e., technology investments and/or M&A)
  • Represent CSG as point of contact for state and national professional societies / trade associations and through speaking opportunities at local and national conferences
  • Collaborate with internal and external partners to publish high impact content focused on improving quality and affordability
  • Evaluate clinical and other data (e.g., quality metrics, claims data, bed-day data, usage data) to identify opportunities for improvement of clinical care and processes
  • Support expansion of OptumHealth Education content into the provider community
  • Participate in response development and delivery to high level questions, concerns and complaints from regulators, accreditors, legal/risk management, employers, healthcare providers, and other stakeholders
  • Manage challenging conversations with appropriate interpersonal dynamics when discussing programs that impact quality and/or affordability and areas of disagreement
  • Deliver group presentations on clinical programs
  • Influence development of technical/clinical communications that will be delivered to external audiences (e.g., new clinical policies, programs, processes)
  • Discuss case information with internal or external parties (e.g., case managers, other medical directors, clinical providers, physicians)
  • Provide feedback to team members and other departments to refine decision making and promote a shared understanding of benefit or coverage decisions
  • Discuss clinical program outcomes, data and performance with providers, employers, accreditors and regulators
  • Solicit or respond to input on clinical initiatives and guidelines (e.g., providers, specialty societies, clinical experts)
  • Assess and interpret complex financial and clinical data to evaluate feasibility of proposed initiatives
  • Identify and implement development resources in response to business needs and regulatory changes
  • 7+ years of clinical practice experience and 5+ years in managed care industry with strong knowledge of managing benefit risk
  • 5+ years of Managed Care experience across the continuum to include Chronic Condition Management, Utilization Management and Preventative Services
  • Familiarity with commercial and government markets and experience setting clinical policy for wellness, case management, disease management and specialized networks
  • Demonstrated accomplishments in the areas of medical care delivery systems, utilization management, case management, disease management, quality management, product development and peer review
  • Business background/experience in addition to a clinical background is a key attribute for success in this role
  • Experience in client-facing customer relationship management
  • Experience with leading, motivating and managing a team
  • Excellent presentation skills for both clinical and non-clinical audiences
  • Strong operational focus with demonstrated data analysis / interpretation acumen, project management, change management, and execution skills
  • Experience in population health management
  • Past success working collaboratively in a highly-matrixed environment
  • Ability to navigate ambiguity and seek appropriate resources/tools
  • Self-motivated and able to work with little direct supervision and drive results with disciplined follow-though
  • Strong strategic thinking and business acumen with the ability to align clinical related strategies and recommendations with business objectives
  • Adaptable and flexible style of collaborating with key stakeholders in setting direction
  • Proven ability to quickly gain credibility, influence and partner with staff, business leaders and the clinical community
  • High integrity with a reputation of a trusted confidential advisor and partner
  • Visibility and involvement in medical community
  • Strong belief in EBM (Evidence Based Medicine), and familiarity with current medical issues and practices
  • Ability to develop relationships with network and community providers
16

Manager, Population Health Management Resume Examples & Samples

  • Lead Population Health Management engagements related to the planning, execution, and organizational activities for KPMG’s Transformation Consulting initiatives in the Healthcare industry
  • Assess and design care coordination systems for clinically integrated networks to reduce hospitalizations and streamline points of care
  • Lead teams for engagements related to population health assessment and development of strategies
  • Design patient risk management stratification and care management programs that reduce cost
  • Manage client and KPMG work teams throughout the project lifecycle by leveraging KPMG’s approaches and frameworks and helping to ensure timely completion of project deliverables and overall project execution
  • Support the development of value propositions that tie clinical, operational and financial performance metrics and performance improvement opportunities to the C-Suite agenda
  • Seven years of experience consulting in the healthcare industry or experience working in an academic medical center, hospital or health system; five years of experience to be in a team coordination leadership position
  • Bachelor’s degree from an accredited college/university with practice management experience; RN and BSN desirable
  • Demonstrated knowledge of PCMH/PCSP programs and the related principles and guidelines preferred
  • Excellent foundational consulting skills: analytical, written and verbal communication, client presence, facilitation and presentation skills
  • Demonstrated understanding of healthcare reform and other key industry trends/drivers, such as population health management, demographics, and technology is required
17

Director of Population Health Analytics Resume Examples & Samples

  • Consultation as the methodological expert in process improvement tools and methods
  • Ability to receive, model, and analyze both payer and EMR data
  • Direct and supervise the PHA and our client’s HIE / data aggregation strategy
  • Lead efforts to measure aspects of healthcare delivery germane to population health (e.g. HEDIS, CMS ACO/GPRO, patient satisfaction, utilization metrics…)
  • Standardization of analytical approaches, commitment to data and analytical quality
  • Demonstration of the ability to facilitate improvement activities designed to improve patient outcomes and reduce costs
  • Articulate strategy in the areas of descriptive, predictive, and prescriptive analytics – and design staffing and software execution strategy
  • Present analytics strategy and results to leadership, clients, and collaborating organizations
  • Ability to effectively direct and manage employees
  • Ability to define and manage the analytics budget
  • 5+ Years of Directly-Related Experience Required
18

Director, Population Health Sales Resume Examples & Samples

  • Build relationships by meeting with senior executives (CEO, CFO, CMO, etc.) to discuss their strategic and operational challenges, present best practice solutions and effectively sell the vision of their capabilities
  • Meet quarterly and annual revenue goals through management of a sales pipeline with pursuits in various stages of the evaluation process
  • Provide insights from marketing visits to inform future research initiatives and new product development inquiries
  • Manage team member to goals, provide formal feedback, and guidance on professional development
  • Must possess a minimum of 5 years post-undergrad experience in at least two of the following
  • Must possess a minimum of five years of commercial experience – track record of successful sales/ownership over a personal revenue target
  • Willingness to travel domestically at least 50%
  • Experience selling SAAS products, preferably in the health care industry
  • Engaging and memorable presentation style; demonstrated ability to build rapport and credibility quickly with an executive-level audience
  • Resilience and comfort with ambiguity – ability to be flexible and adaptable in a changing environment
  • Receptive to feedback, coaching and constructive criticism; ability to learn from mistakes
  • Consultative-based sales experience
  • Experience identifying market trends, presenting in a leadership forum and leveraging to inform overall go-to-market strategy
19

Director, Population Health Management Resume Examples & Samples

  • Lead complex projects including affordability analyses around ACO medical and pharmacy expense, business analyses, documentation of business requirements, defining current and future scope of work
  • Create and manage ACO clinical affordability projects with internal partners, including but not limited to UHC pharmacy, other clinical and network affordability teams and ACO pilots. Provide project management to each initiative and analytics to track results
  • Close partnership with Medical Director, other Population Health Management leaders and ACO/CCO leadership and Optum PHM programs to create innovative solutions and process enhancements to drive financial and quality success, national and LOB alignment in ACOs and CCOs
  • Provide Clinical direction and support to CCO program/clinical model enhancements including but not limited to Behavioral Health Integration project
  • Lead Clinical Model development and process support for the CPC+ program in all approved states and LOB to align with ACO Clinical Model and meet the CMS requirements for the program, includes supporting reports, technology and core team and representation on the UHC-CMS work team for CPC+
  • Provide Clinical assessment and quality linkage to ensure ACO and CPC+ quality and financial success
  • Create linkages between CAHPS and Member Engagement at ACO and CCO sites, all LOB
  • Create programs and implement ACO and CCO specific pilots and national programs to improve CAHPS and Member Engagement with these strategic partners
  • Oversee budget planning and management for CAHPS and Member Engagement vendors
  • Champion change and innovation including using emotional intelligence as a core in driving innovation
  • Have the ability to cultivate discussion, actively listen and embrace new ideas and then bring those ideas to a product/process improvement
  • Establish an organization focus and direction regarding models of care that incorporate needs of all lines of business focusing on quality and operational efficiencies across the organization
  • Establish recognition of PCCM as the site for enterprise wide model of care alignment and opportunity to use ACO partners as learning labs for new initiatives, best practice diffusion and pilot sites for non-ACO practice enhancements, all LOB
  • Develop and lead programs meeting business strategies for successful ACOs/practice transformation, support CCO expansion and incorporate NEXUS product into ACO processes and successful clinical model enhancements
  • Assist Clinical Transformation national, market and regional teams in assessment and clinical training tools for all LOB
  • Create and measure business and clinical outcomes with respect to the provision of clinical support for practice transformation and successful transition of practice to shared savings/risk contract – including ADDC analyses, monthly report production oversight, and market day to day questions
  • MBA or Master’s degree
  • At least 10 years of healthcare business experience spanning cross-functional area of general management, strategic planning, business development
  • Demonstrated ability to identify, create and track clinical program opportunities for population health management, experience in multiple lines of business a plus
  • Broad understanding of HEDIS and how it's used to drive business growth and / or efficiencies (HEDIS, CAHPS)
  • Excellent business acumen, program management and relationship skills
  • Exceptional ability to work in rapidly changing environment and provide strong change management leadership
  • Demonstrated ability to develop, execute and improve Clinical Programs across a large or multiple business units
  • Prior experience in an innovation field or long term project or evidence of driving successful clinical practice innovative solutions
  • Clinical Degree, such as RN, PharmD, PA (Asset)
20

Senior Population Health Analyst Resume Examples & Samples

  • Epic certification in Ambulatory and Reporting Workbench required
  • Analytical and business process development skills
  • Expertise IT systems and the tools needed to effectively summarize data highlight exceptions, view trends
  • Working knowledge of health reform issues and regulation developments impacting primary care
  • Strong verbal, written and presentation communication skills. Effectively present information in one-on-one
21

Manager, Population Health Analytics Resume Examples & Samples

  • Extensive experience in health care analytics, population health analytics or medical economics or combination of related consulting experience
  • Demonstrated ability to convert large databases of data into usable information and actionable insights
  • Proficient in the Microsoft Office Suite with advanced Excel and Access skills
  • Experience with Tableau required
  • Experience with SQL, SAS, Epic preferred
  • Highly motivated individual with strong analytical, planning and communication skills and ability to work within a highly matrixed environment
22

Population Health Manager Resume Examples & Samples

  • Gather and manage quantitative and qualitative patient data
  • Conduct patient outreach, within the existing infrastructure of the population health program, to help educate and schedule patients for relevant follow-up testing and appointments
  • Support practice staff in the development of processes to proactively manage target populations
  • Understand Primary Care practice requirements with respect to optimal and coordinated health care for target patient populations
  • Manage patient data collection, prepare patient data collection templates, coordinate patient data to a format convenient for analysis, and prepare reports on findings, interpretations and final recommendations for each practice
  • Contributing to quality improvement and process design of population health efforts
  • Assist with development of the study’s intervention protocols and procedures
  • Train, observe and provide relevant stakeholders with feedback regarding the study interventions
  • Create and manage patient registries and provide the data required to meet the needs of the members of multidisciplinary, cross-departmental work groups created for this study
  • Conduct ad hoc analyses as needed for each practice
  • Provide data management, coordination, and possibly patient outreach for target patient populations
  • Gather and sort required data and generate pre-established reports
  • Synthesize, sort, format data, and generate ad-hoc reports
  • Present safety and quality related oral presentations to departmental and hospital constituents
  • Answer and/or research questions on problems the clinicians have identified
  • Recognize and report data inconsistencies to appropriate personnel
  • Conduct the study according to protocols and procedures using good clinical research practice as described by the Partners Human Research Committee
  • Generate regular reports to assess study progress
  • Design, develop and present refined spreadsheets, reports, whitepapers and slide presentations
  • Collaborate with care teams to establish population-appropriate patient outreach, education and scheduling of follow up appointments and procedures
  • Provide data to the care teams to properly perform these processes
  • Monitor and correct patient attribution to the practice and the care teams within the practice
  • Serve on groups and committees as needed or assigned by the PI
  • Bachelor’s degree required. Masters degree preferred
  • Proven project management experience in healthcare related field with a minimum of 3-5 years experience
  • Experience working in large, complex healthcare organization preferred
  • Experience in program development in quality measurement and/or improvement or patient safety preferred
  • Excellent judgment and ability to interpret and follow protocol requirements
  • Data analysis and application of quality improvement principles and techniques, including presentation and problem solving techniques preferred
  • Experience in clinical research, including management experience, research coordination, and statistical analysis
  • Strong familiarity with medical terminology and diagnosis coding preferred
  • Training in process improvement and change management techniques preferred
  • Experience with LEAN or other forms of rapid cycle improvement a plus, but not required
  • A 2-year commitment is preferred
  • Excellent interpersonal skills required for working with hospital leadership and staff. Ability to demonstrate professionalism and respect
  • Patient focused or customer service experience preferred
  • Working knowledge with electronic health records and other healthcare IT systems desirable, experience using Epic preferred
  • Strong organizational skills and ability to prioritize tasks
  • Project management, team lead or managerial experience skills preferred
  • Must be able to work independently to complete work and to meet stringent deadlines
  • Proficiency in Microsoft Word, PowerPoint, Excel, Access, Visio and MS Project
  • Experience w/REDCap preferred, but on the job training is available
23

Population Health Program Coordinator Resume Examples & Samples

  • Organized and motivated by a fast-paced environment
  • Able to manage multiple tasks/projects simultaneously
  • Proficient in review and assess needs quickly
  • Strong with the use of computer software tools and data files
  • Comfortable with continuous change and self-initiating
  • Able to complete documentation in a quick and efficient manner (will be in legal medical record and other software systems developed for care management and population based program metrics)
  • Use motivational interviewing and active-listening skills when assessing patient conditions, problems and interests
24

Population Health Sales Specialist Resume Examples & Samples

  • Identifying potential targets and securing pilot sites
  • Securing new accounts from a national target audience
  • Meet and develop relationships with key buying influences in targeted sales pursuits
  • Identifying, qualifying and mapping our solutions to buyers needs
  • Leading complex sales pursuits individually or support as necessary in a matrix role
  • Presenting as an industry expert on Population Health at industry functions
  • Being a trusted subject matter expert (SME) to peers, customers and buyers
  • Following all laws and established buying processes as established by our buyers
  • Accurate, timely forecasting and sales reporting
  • Healthcare Information Technology
  • Population Health Management
  • Care, Utilization and/or Disease Management
  • Clinical background such as RN, Pharmacy or Medical Technician
  • Consultative/Clinical IT selling experience - 5 to 8 years
  • Healthcare or Clinical Consulting – 3 to 5 years
  • Public Sector sales – 3 to 5 years
  • BS/BA degree
25

Population Health Clinic Informatics Analyst Primary Care Operations Days CHI Health Alegent Creighton Resume Examples & Samples

  • Develops, monitors, and distributes quality reports for all providers on regular basis and as needed for Patient Centered Medical home plan administration
  • Designs, runs, and distributes routine and ad-hoc computer reports from EPIC, Cogito Slicer Dicer, and other software tools
  • Works with medical leadership, management, and other employees to collect report requirements. Responsible for timely turnaround of quality/informatics data and reports to requestor
  • Coordinate the capture and presentation of clinical information. Incorporate management feedback to design and develop clinical dashboards including key quality metrics agreed upon in the strategic planning process
  • Implement appropriate controls and procedures to assure complete accuracy in quality/informatics reporting processes. Develop audit and review procedures to assure that reports are accurate and processed in a timely manner. Maintains documentation and statistics of all reports generated, ad-hoc reporting databases, and query inventory listings
  • Work closely with assigned clinics on their Patient Centered Medical Home (PCMH) /Population Health goals and participate in strategic planning and providing guidance to clinics on operationalizing PCMH. Collaborates with Enterprise Intelligence Development team to develop and report Quality scorecards and dashboards on routine basis
  • Troubleshoots or forwards as appropriate to AHC Support, end-user issues and questions regarding various EPIC and related computer applications and other software questions
  • Participate in all mandatory safety, security and infection control programs, as well as those required and provided by the department
  • Demonstrate work practices consistent with CHI Health and department-specific safety, security and infection control policies
26

Population Health Analyst Resume Examples & Samples

  • Develop a comprehensive understanding of the VCP network strategy, goals and the technology used for clinical analytics and logistics of the data systems
  • Work collaboratively with the leadership team to identify informatics, reporting requirements and desired outcomes measures
  • Prepare business related analyses and research on clinical or claims data to identify trends and opportunities that drive management or clinical initiatives
  • Analyze data to derive business insights and identify potential issues
  • Aide in executing reporting processes required to support population health initiatives, such as physician profiling, patient registries, cost/quality/utilization metrics, risk analytics and trending
  • Assist the Quality Management Clinical Team with data interpretation for providers and practices
  • Interpret and communicate informatics effectively with internal stakeholders
  • Exhibit commitment to developing a team environment with other VCP staff
  • Provide analytics and data support for Board, Committees, and others as directed
  • Possess strong analytical and critical thinking skills used to solve complex business problems
  • Treat everyone with respect and professionalism at all times in all interactions, both written and verbal
27

Assistant Commissioner & Director of Office of Population Health Resume Examples & Samples

  • Ability to establish credibility and be decisive; recognize and support organizational priorities
  • Knowledge of the principles and practices of population health, public health service delivery and the frameworks of health care systems within and outside of a clinical setting
  • Demonstrated ability to engage partners and a solid understanding of the formal and informal processes of individuals and groups collaborating
  • Capacity to develop and implement effective stakeholder strategies and to promote a culture of partnership, transparency and inclusion
  • Exceptional management, leadership, communication, strategic planning, project management, visionary, and interpersonal skills
  • Skilled in analyzing and succinctly articulating difficult and often complex situations in an effective manner, while presenting these complexities with an eye towards the development of strong recommendations and prescriptive conditions
  • A strong understanding of Quality Improvement or Performance Management for use in program development and implementation
  • Critical thinking skills, using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems
  • Record of managing a team of professional staff including, senior level directors; Ability to lead, inspire and empower demonstrating confidence and executive presence
  • Thoroughness, independence and excellent written and oral communication skills; and
  • Proficient usage of Microsoft Office products including Word, Excel, PowerPoint and Outlook
28

M HIS Population Health Clinical Analyst Resume Examples & Samples

  • Bachelor's degree or higher in HIM (RHIA), Health Information Technologies, Nursing or other healthcare clinical background from an accredited university
  • Certified training in ICD-9 and ICD-10 coding skills
  • Minimum of five or more (5+) combined years of experience in the healthcare industry working with quality outcome measures, clinical coding and/or pay for outcome methodologies
  • Master's degree in HIM, Nursing or other healthcare clinical background from an accredited university
  • Preferred qualifications include a RN with thorough understanding of healthcare delivery processes and best practices, Health Information Technology (HIT) application environment, and HIT configuration/build tools
  • In depth knowledge of PPC, AA, PFP, PSI, PQI, CRG, NQF and VBC policy and pay for outcome policy
  • Excellent knowledge of disease and procedure classification systems, ICD-9, ICD-10, CPT, HCPCS and thorough understanding of official coding guidelines
  • Strong background in Classification and code-based quality and payment methodologies (e.g. MS-DRGs, HACs, APR DRGs, Pay for Outcomes, CRGs)
  • Experience with healthcare data and HIPPA requirements (inpatient and outpatient data, billing claims, healthcare informatics etc.)
  • Strategic thinker, creative, analytical, methodical, clear writing and messaging ability, fast learner and strong business acumen
29

Associate Population Health Director Resume Examples & Samples

  • Product Development, Sales Solutioning and Support
  • Bachelor Degree or equivalent work experience
  • 5+ years of product management / product development or health care experience
  • Demonstrated ability to achieve goals in a matrix environment
  • Proficient in interpreting and analyzing data to support decision making
  • Excellent Microsoft Office skills, including advanced Excel, Power Point Skills and Word skills
  • Demonstrated ability to prioritize projects and deliverables
  • Experience with reading and responding to an RFP
  • Ability to quickly understand and make decisions when information is limited
  • Willingness to proactively seek and find contacts to pull together facts
  • Ability to travel, 25%
  • Strong background and / or understanding of the healthcare industry, clinical operations and case management experience
  • Experience with Medicaid or Medicare populations
  • Population health experience
  • Experience with special Medicaid populations, including LTSS, ABD, SMI, DD, Foster Care
  • Product development, product management, operational or financial strategy development experience within a matrix organization
  • Project (program / product) management experience
  • Experience with effectively presenting to Senior Management
  • Ability to think and act strategically, and as well as execute tactically with bias toward action
  • Ability to manage projects simultaneously and achieve goals
  • Excellent follow through, attention to detail, and time management skills
  • Strong interpersonal skills; brings an ability to work collaboratively with a wide range of individuals at all levels of the organization
30

Population Health Analytics Resume Examples & Samples

  • Bachelor’s degree in Business, MIS or CIS or equivalent work experience
  • Demonstrated proficiency in Microsoft Transact SQL
  • Report and process automation
  • Demonstrated experience in working with teams across multiple organizations
31

Executive Director, Population Health Resume Examples & Samples

  • Participate with the VIPN Board of Managers and all organizational committees meetings
  • Responsible for leading and managing the key day-to-day operational aspects of VIPN’s network development, management and risk arrangements
  • Develop transformative solutions drawing from national best practices, analytics, personal expertise and creativity to deliver an innovative network of providers
  • Define market network needs and gaps in current capabilities. Assess network adequacy to resolve the gaps for all provider types (acute, ambulatory and post-acute) and build networks necessary to offer to payers and employers cost efficient quality solutions for their populations
  • Establish physician recruitment priorities and oversees physician recruitment program
  • Collaborate with MedProVidex in the development and maintenance of database of physician network participants and other administrative support from the delegated Managed Services Organization responsibilities including creating and managing annual operating budget, hiring and management of VIPN staff
  • Responsible for evaluating physician compliance with quality standards, as identified in weekly, monthly and quarterly reports
  • Partner with analytics team to develop network reporting tools to evaluate and develop actionable reports to communicate to providers regarding risk assessments and cost efficiency opportunities
  • Partner with VIPN Board of Managers to establish services and results necessary to successfully manage risk contracts
  • Establish trusted partner relationships to expand VIPN role in payer strategies
  • Support the Payer Committee in developing payer relations strategy, support local negotiations as necessary, including issues pertaining to prioritization, on behalf of VIPN
  • Enhance, monitor and administer VIPN physician incentive program payments
  • Serve as direct administrative liaison between VIPN and the local sponsoring hospital executive team
  • Serve as primary local liaison to local Dignity Health legal counsel
  • Support program communication plan and execution
  • Drive initiatives that organizationally contribute to long-term operational excellence
  • Ensure the long term financial viability of the VIPN CI program
  • At least 5+ years of physician practice management and/or physician network management experience with payer relations/contracting experience preferred. Managed Care Network or Provider Relations experience is a plus
  • Undergraduate degree required. Master’s degree in health administration or other related field preferred
  • Candidate should also have relevant experience and demonstrated success in business development
  • Strong skills developing and implementing operating plans and analyzing both financial and quality data
  • Previous familiarity with various physician compensation plans, incentives programs and contracting arrangements
  • In-depth knowledge of the healthcare industry
  • Demonstrated skills in the areas of supervision, management, written and verbal communication, judgment, problem-solving, presentation and public relations
32

Population Health Analyst Resume Examples & Samples

  • Population Health Analyst has an understanding of population health analytics, and an understanding of clinical and claims based data systems and measures
  • This position will use ACN’s claim data warehouse, population health tools, electronic health record, and other reporting systems to provide clinical and claims related reporting and analytics
  • The Population Health Analyst will provide support for data integrity and data validation in the production of data that drives operations, financial and quality queries
  • Analyzes and reconciles claims data for bundled payments, shared savings, and other payment innovation initiatives. Track success metrics and various reporting needs for participating facilities and as guided by relevant entities
  • Develops trend analysis reports that monitor key performance indicators and compares them to internal and external benchmarks and uses this data to assist leadership in decision-making, planning and implementing performance improvement strategies
  • Assists with identifying statistically significant patterns and trends
  • In collaboration with Director, Data Analysis, key stakeholders, IT, etc., designs and maintains regular dashboards on quality, financial information outcomes, population health management (PHM) measures, and other metrics
  • Assist ACN management with additional duties related to electronic health records, data support and analysis, and HIPAA security requirements not otherwise covered in the job description
  • Advanced knowledge and use of both SAS and SQL
  • Demonstrated excellence in people/process management and planning
  • Strong leadership, presentation, communication (written/verbal) and information gathering and the ability to interact with various client groups
  • Ability to create, manage and enhance customer and vendor relationships
  • Strong knowledge of MS programs e.g. Word, Excel, Access, & PowerPoint
  • Identification with and support of the Mission and Values of ACN and its Sponsors
33

Manager Population Health Resume Examples & Samples

  • Integration of programs within the population health services, with integration with the clinical care delivery services
  • Responsible for the oversight of billing and financial targets for the population health services
  • Data analytics and recommendations to the Director of Population Health and Quality, related to the optimization of population health services
  • Facilitation of integration of new innovations for population health services to internal and external partners
  • Explore and identify evidence-based solutions related to population health services. Create and support multi-disciplinary project teams to advance product offerings related to population health services
  • Clinical care experience and leadership in the ambulatory setting required
  • 5 years proven program management experience integrating services within a clinic setting
  • Strength in detail management , with financial management strongly encouraged
  • Possess strong foundational knowledge in change management, measurement , and financial aspects
  • Very strong human relations and team building skills are required to effectively perform in this role
  • Strong, written, verbal and analytical skill
  • Ability to work effectively with all levels within QuadMed and the client organizations
  • Highly organized yet can work in a flexible, fast-paced environment
34

Director Population Health & Quality Resume Examples & Samples

  • Directs on-going Quality Improvement activities for clinical services to monitor clinical compliance with standards and regulatory requirements. Serves as member of the Quality Committee
  • Patient Safety – oversees the creation, implementation and measurement of patient safety in the clinics,
  • Working with product development and senior leadership, to develop innovative strategies supportive of our population health directives
  • Clinical experience, with understanding of financial stewardship, to assist the CMO in budget guidance related to population health services and quality
  • Partner to serve as SME for internal and external partners related to quality and population health. Collaborate with sales and account management team to assure alignment of client issues with the clinical team to assure we are the client’s trusted partner
  • Ensure client expectations regarding population health management matches services sold through clearly defined product offerings and operating models
  • Ensures data integrity and application to foster strategic discussions regarding current and potential services offered to clients to drive initiatives improve health outcomes
  • Support Establishment of appropriate performance guarantees related to population health services – in conjunction with quality director
  • Assist in development of RFP responses, new client proposals as well as involvement in finalist presentations as appropriate related to population health of chronic conditions
  • Collaborates with administration, clinical employees, consultants, professional associations, community agencies, and institutions to improve the quality of services and to resolve identified clinical problems
  • Communicates and interprets policies and procedures to clinical staff, and monitors staff practices and implementation
  • Oversees and supports the Development, maintenance, and implementation of Clinical Care policies, protocols, and procedures that conform to current standards of ancillary medical practice, QuadMed philosophy, and operational policies while maintaining compliance with state and federal laws and regulations
  • Maintains working knowledge of standards of the AAAHC Accreditation and State and Federal regulations related to Medical Staff organization assuring continued maintenance of accreditation , and advanced accreditation as deemed necessary by executive decision
  • Directs the processing of all Medical Staff and Allied Health Staff credentialing, re-credentialing, privileging, collaborative agreements, and insurance enrollment, as needed, in accordance with policies, regulations, AAAHC standards, and state and federal law. Supports AAAHC Survey preparation for the medical staff/leadership function, including staff and medical staff education regarding accreditation standards
  • Coordinates the Medical Directors and Credentialing Committee in development of privilege criteria, privilege delineations, and other documents necessary to ensure an effective credentialing process
  • Develops a departmental operating and capital budget
35

Product Manager, Population Health Management Resume Examples & Samples

  • Think strategically, and creatively, about how the consumer experience should work
  • Translating a vision to processes and requirements
  • Navigate and influence multiple cross-functional teams in a complex, matrix work environment
  • Support the development of market and sales strategies and value proposition
  • Forecast revenue or savings opportunities associated with product development initiatives
  • Manage cross-segment projects and initiatives that require problem solving, relationship building, influencing and analyzing
  • Adapt departmental plans and priorities to address business and operational challenges
  • Influence innovation across teams to ensure aligned; cohesive progress across technology, marketing, and service operations
  • Lead strategy and execution for technology-enabled decision making tools, including telemedicine, and plan cost estimation capabilities
  • Empower consumer decision-making through the development and management of consumer advocacy technology and service capabilities
  • Support strategic client relationship management for product performance and enhancements
  • Lead vendor relationship management for strategic vendor partners
  • 5+ years of Product Management, Product development or Project Management experience
  • Proficiency with MS Office applications with min of 3 years of experience using these tools
  • Previous experience working and accomplishing goals in a matrix environment
  • Strong interpersonal skills - able to manage client and vendor relationships and work
  • Strong analytical and financial skills
  • Demonstrated ability to work collaboratively and influence others
  • Effectively communicate at all levels of the organization
36

Population Health Sales Executive Resume Examples & Samples

  • Bachelor’s degree in business, sales, marketing, or equivalent training in business or sales management
  • 5+ years experience in healthcare IT sales
  • Proven track record of success in complex sales over a sustained period
  • Strong working knowledge of population health; solid understanding of value-based care initiatives
  • High degree of competency in population health data aggregation, analytics and/or connectivity solutions
  • Indepth understanding of healthcare IT industry
  • Experience interacting at the C-level
  • LI-CM1
37

Population Health Performance Improvement Engagement Leader Resume Examples & Samples

  • Helps define process improvement challenges, measure current process performance, analyze root causes, and develop targeted process improvement opportunities with business partners
  • Leads performance improvement assessments and implementation changes designed to reduce variation and reduce or eliminate unnecessary processes and tasks
  • Trains and coaches project teams
  • Demonstrates the ability to communicate effectively to direct and motivate team and others, maintaining a persuasive and credible presentation style at all levels of the organization
  • Serves as a facilitator and coaches others to serve as agents of change within their organization
  • Utilizes strong analytical skills and a process focus
  • Presents a progressive, flexible and team oriented approach
  • Exhibits strong planning/organization and project management skills
  • Performs scoping and resource allocation recommendations for client engagements
  • Assumes responsibility for identifying and conducting benchmarking and research for best practices and leading edge methodologies
  • Maintains responsibility for expert level application and knowledge transfer of transformation core competencies
  • Demonstrated success in forming and managing client Director and CXO level relationships Demonstrate excellent organizational skills
  • Demonstrate excellent project management and organizational skills
  • Proficiency in MS Office
  • 4 plus years of experience with performance improvement
  • Lean six sigma certification
  • Ability to travel up to 40-50%
  • Live in, or be willing to relocate to, Kansas City or live in a virtually approved city
  • Knowledge of Cerner Solutions or EMR
  • Experience leading teams to improve clinical and operational processes
  • Healthcare information system implementation experience
38

Clinical Consultant Population Health Resume Examples & Samples

  • Forging relationships across the health and social organisations - Community, Mental Health, Primary Care, Acute, Social Care and Commissioning Groups
  • Identification and delivery of the value/benefits or the population health programme
  • Preparing the client for long term continuous improvement beyond the early phases of the programme
  • Supporting the Cerner Performance Improvement team in their analysis and workshops
  • Supporting appropriate and best design principles during localisation of population health applications
  • Ensuring clinical and operational adoption of new ways of working and use of population health applications
  • Owning the Cerner responsibilities to the clinical safety case
  • Supporting other assurance activities related to information governance (data sharing, consent, sensitive data)
  • Post implementation optimisation and documentation and publication of realised value
  • Continuous refinement of the Population Health Consulting Framework plan and collateral for use in UK/EU projects
  • Sales team support (leveraging the learning from the first of type projects)
  • Working in accordance with corporate and organisational policies and procedures
  • Bachelor's degree in Health, Business, Health IT related
  • Professional healthcare qualification e.g. Dip Social Work
  • Experience working in a health or social care setting in either a clinically managerial/operational role
  • 3 years of health or care clinical/operational management in the NHS, Social Care, Local Government or Voluntary
  • Experience leading and delivering organisational change
  • Able to create relationships with professional care givers, across multi-disciplinary teams through to Executive levels and across numerous care organizations
  • Ability to engage in all phases of a project including sales business development, client relationship management, implementation management and on-going operations
  • Deep understanding of all healthcare organisations, policies affecting healthcare and providers of health (physical and mental) and social care
  • Ability to manage multiple projects with competing demands running simultaneously
  • Ability to travel and work remotely up to 60%
  • Master's degree Health, Business or Health IT
  • Analytical skills including financial, process and risk analysis
  • Change management or Performance improvement qualifications (Six sigma/lean etc.)
39

Population Health Analyst Resume Examples & Samples

  • Work in relational databases and Hadoop-based data mining, develop data driven solutions accurately and timely that answer critical questions, solve problems and support strategic and operational initiatives utilizing BI tools such as Microstrategy and Tableau
  • Employ excellent statistical and analytical, interpersonal, organizational, verbal and written communication skills, and ability to independently manage and prioritize multiple projects
  • Working closely with Executives, Medical Directors, Physicians to identify data points, define metrics, determine analysis, and reporting design for clinical, financial impact and patient outcomes
  • Collaborate with various departments within Sutter such as Finance, Quality, Variation Reduction team, and Business & Planning, etc. as well as EPIC team and PAMFRI to understand organization’s data structure and content, and other initiatives to support and strengthen business process and outcomes analysis for Managed Care
  • Design, develop and automate front-end presentation tools such as charts, tables, and dashboards to present various data inquiries to non-technical audiences. Possess ability to interpret and answer questions from a diverse group of people with various technical and clinical backgrounds
  • Required: Bachelor's - Computer Science, IT or Healthcare; Or equivalent education/experience
  • 6-9 years with relational database tools, SQL server
  • 6-9 years Epic front end process into data element of Epic back end of Clarity data warehouse
  • Electronic Health Record Certification - EHR Preferred
  • ICD10, CPT and HCPCS codes
  • Relational database programming and statistics, R and/or Python
  • Critical thinking, statistical, analytical, organizational and attention to detail
  • Ability to manipulate and analyze complex, high-volume, high dimensionality data from varying sourced
  • Ability to develop and maintain clinical metrics, analyze data and produce clear and concise reports including interpretation
  • Ability to communication complex quantitative analysis in a clear, precise and actionable manner
  • Expertise working with a wide range of customers including executives, medical directors, physicians, Directors and managers in defining clinical metrics and developing reports to meet customer requirements
40

Population Health Analyst Resume Examples & Samples

  • Graduate degree (Master's, FCAS or Ph.D.) in a relevant technical field, or 6+ years’ experience in a relevant role such as operations research, applied statistics, data mining or healthcare Actuary Required
  • 6-9 years with relational database tools Required
  • 3-5 years working with Epic front end processes and Clarity database Preferred
  • Utilizing business intelligence tools such as Microstrategy and Tableau
  • Strong knowledge of relational database programming and statistical packages (e.g. Hadoop, R and Python)
41

Population Health Operations Specialist Resume Examples & Samples

  • Possess the ability to deal with ambiguity
  • Demonstrates the ability to work on multiple projects simultaneously and prioritize work to meet adapting deadlines
  • Displays exemplary organizational skills
  • Excellent computer skills, including Microsoft Office suite
  • Ability to communicate clearly and determine appropriate communication medium (e.g. phone, face-to-face meeting, e-mail, instant message, voicemail)
  • Bachelor's degree required or equivalent work experience
  • Residing in or able to relocate to Kansas City, MO
42

Population Health Analyst Resume Examples & Samples

  • Population Health Management: Supports the implementation of population health management strategies as outlined in the Michigan Medicaid Managed Care contract, including the development of processes to collect data and implement new managed care programs related to the social determinants of health
  • Healthy Michigan Plan Healthy Behaviors Protocol: Leads the revisions to the Healthy Michigan Plan Healthy Behaviors Protocol and the implementation of all Healthy Behaviors Incentive Program related activities, including development of online/cellular applications, an online course for physicians, all reporting requirements and monitoring of incentives
  • Health Equity: Leads the collection and analysis of performance measure data stratified by race/ethnicity and other demographic characteristics to identity health disparities; provides assistance with the implementation of evidence-based strategies to reduce identified gaps in care
  • Maternal Care Quality Improvement: Supports efforts to improve maternal and infant health outcomes in Michigan Medicaid through CMS Maternity Core Set measure reporting, support of the MIHP program integration with Medicaid managed care, assisting on grant-related activities for the CMCS grant entitled Improving Maternal and Infant Health Outcomes in Michigan Medicaid through Access to Effective Contraception (including working on the developmental contraception measures), and facilitating efforts related to the Michigan Infant Mortality Reduction Plan
  • Performance Measures: Supports the performance measure collection and reporting efforts of MDHHS including the quarterly Performance Monitoring Report, the metric for behavioral and physical integration, facilitating the MDHHS/MHP data vetting workgroup, CMS Adult and Child Core Set reporting and analysis, utilization of Symmetry software by MDHHS, and development of new measures to meet federal and state legislative mandates as required
  • Quality Improvement: Provides assistance as needed for quality improvement and population health management initiatives initiated by MDHHS
  • 3+ years of Project Lead and/or Business/Quality Analyst experience specifically related to Health-related Quality Measures, Performance Measures and Population Health Management
  • 3+ years of Medicaid industry experience
  • 2+ years of working with technical developers to strategize solutions to align with business requirements
  • 1+ years of working with Symmetry tools
  • Experience with the State of Michigan
  • Previous experience working with Data Modelers and developers,
  • Quality Analyst experience in a state government health environment
43

Population Health Integration Architect Resume Examples & Samples

  • Has strong client facing presentation and facilitation skills (may be demonstrated through teaching client or associate classes or presentations)
  • Basic computer skills, including Microsoft Office suite
  • Ability to travel and work remotely (up to 20%)
  • Must live in, or be willing to relocate to, Kansas City
  • 4-7 years’ experience in healthcare computing, including 1-3 years of managing enterprise wide clinical systems
  • Has participated in multiple phases of an integrated health system implementation; ideally this is at more than one client site and more than 1 venue; however, a single client setting will meet this requirement
44

Population Health Interface Architect Resume Examples & Samples

  • Ability to work overtime and irregular hours when needed, including on call rotations
  • Bachelor's degree in CIS, MIS, IS, Computer Science, Engineering, or Business Administration with emphasis in information systems
  • 3+ years’ experience with systems management
  • Ability to travel up to 20% of the time (if applicable)
  • Live in or willing to relocate to the Kansas City area
  • SQL and/or Interface skills
  • Significant experience working with relational databases
  • Experience with HL7, X12, CCDs and/or proprietary formats
  • Knowledge of the extract, transform, and load (ETL) process
45

Population Health Executive Resume Examples & Samples

  • As the Sustainability and Transformation Plan (STP) patches mature we envisage the role to own the client relationships in an STP. At present our Population Health Executives are focused on the immediate client provider network
  • Builds trusted relationships with key client executives and being integral in key discussions concerning strategy, structure, management and operations across the network of organisations, through leadership and change management skills
  • Directs the overall Cerner Population Health Consulting relationship with all the Cerner Services leadership teams and the client
  • Provides the connection and thought leadership between the client’s business strategies and Cerner’s consulting value proposition
  • Provides executive oversight into population health engagements to ensure strategy is executed and value is delivered
  • Bachelor’s degree in a healthcare or business related field
  • 5+ years of recent health or care work experience in clinical/operational management in Healthcare, Social Care, Local Government or Voluntary sectors
  • Performed in at least 1 senior management role
  • Proven experience leading and delivering organisational change and transformation
  • Ability to manage multiple projects simultaneously, across the continuum of care and/or business spectrum
  • Outstanding written, verbal communication and presentation skills, potentially participating as a key contributor for publications and/or public speaking
  • Ability to travel and work remotely up to 60% of the time
  • Masters in Healthcare, Healthcare IT, or Business
  • Professional qualification in Healthcare (in particular in General Practice, and Social Care)
  • Experience with Healthcare Informatics (worked with or for a Health Information related company)
  • Working in or leading new incentive based programmes – Value/Outcome/Quality orientated approaches to reimbursement
  • Experience in financial modelling and risk/gain-share arrangements
  • Working with or leading on new models of care
  • Working with or leading care co-ordination/management, prevention/wellness programmes
  • Deep understanding of Information Governance
  • Experience in forming complex governance structures across an integrating network
  • Experience in public engagement related to health or social care activities
  • Experience with workforce planning, creating staff incentive models
  • Ability to manage contractual agreements and participate in contract development
46

Population Health Integration Architect Resume Examples & Samples

  • Knowledge and experience working with Cerner solutions
  • 4-7 years’ experience in healthcare computing, including 1-3 years managing enterprise wide clinical systems
  • Ability to travel and work remotely up to 40%
47

Population Health Technical Solution Architect Resume Examples & Samples

  • Able to manage multiple projects and deadlines
  • Skilled in Microsoft Office Suite (specifically Excel, Word and PowerPoint)
  • Ability to travel 10%
  • Must reside in or be willing to relocate to the Kansas City area
  • 5+ years of SQL experience
  • 5+ years of Analyzing Data experience
  • 5+ years of Report Development (Business Objectives and Tableau)
  • Minimum of 3 years working directly with clients
  • 2+ years working with Cerner Solutions
48

Senior Director, Population Health Resume Examples & Samples

  • Monitors, evaluates and redesigns program practices and processes to meet or exceed all regulatory and accrediting agency requirements
  • Oversees the day to day operations of the Population Health Program and linking respective business operations/business strategy with financial results. Additionally will work with Practice Leads to ensure that established clients goals aligned with PHM are met
  • Actively participates in the performance planning, competency and individual development planning process
  • Provide leadership in developing and implementing care management initiatives to achieve overall program goals and identifies areas of risk and opportunities to enhance business models
  • Oversees the development of process, policies and practices of internal and external partners to maximize the value of the population health management program. These include: product , compliance, quality, operations, and practices teams
  • Oversees the recruitment and educational needs of Care Management staff, providers and others. This can include an extensive orientation program, cross-training and proactive approach to case management
  • Serves as a highly visible leader, colleague, and mentor, providing leadership, direction and education
  • Ensures that technology and software systems (CCOO) support workflow with efficient clinical logic, standards of practice and regulatory and accreditation requirements
  • Provides guidance for professional development of team
  • Ability to multi-task in a fast-paced clinical setting
  • Aptitude for coaching, training and developing new teammates
  • Strong communication, team leadership and project management skills
  • Ability to collaborate and build strong client relationships across all levels of the organization including clinical staff, physicians and administrative leadership to meet deliverables
  • 10+ years of professional experience required; minimum 5 years experience in healthcare, working with providers and/or payers at a management level
  • Experience managing operating departments in hospital/health/Payor systems
  • At least 5 years management experience with large, geographically disparate teams
  • Bachelor’s degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college
  • MBA/MPH/MHA preferred
49

Population Health Engagement Leader Resume Examples & Samples

  • Demonstrated success in forming and managing client Director and CXO level relationships
  • Experience managing multiple small and moderate sized teams of people with disparate roles
  • Ability to travel up to 80%
  • Live in, or be willing to relocate to, Kansas City
  • Project Management Professional Certification (PMP) a plus
50

Population Health Resource Associate Resume Examples & Samples

  • Make home visits and other contacts with clients, as necessary. Coordinates regular practice visits and attends provider meetings to promote coordination of patient care
  • Accompany clients to scheduled appointments and/or referral sites, as needed
  • Serves as liaison to health/social services providers to build and maintain effective relationships with physicians, site leadership, hospital staff and other community stakeholders to ensure timely and appropriate patient follow-up
  • Provides regular oversight (including accompaniment into the field) of new hires and completes required performance adherence to program standards and implements improvement and development plans as needed
  • Utilize leadership principles to mobilize team to achieve positive outcomes
  • Conduct follow-up on outstanding matters to insure they are successfully resolved
  • Represents program interests at internal and external meetings
  • Collect and analyze key statistics (disease registries, biometrics, care management productivity, etc.) to ensure adherence to established care management protocols and benchmarks and investigates methods for improving service delivery
  • Complete chart reviews and facilitate peer review process among assigned staff members
  • Utilizes data to implement individual and program-level performance improvement activities (standardization of care, establishment of disease and population health metrics, consistency of reporting, information flow and management, job functions)
  • Assess training needs of new and existing staff, identifies and coordinates continuing education, in-services and staff development opportunities to ensure that skill-sets adhere to established core competencies
51

Population Health Executive Resume Examples & Samples

  • Primarily focuses on building trusted relationships with key client executives and being integral in key discussions concerning strategy, structure, management and operations of an organization through leadership and change management skills
  • Directs the overall Cerner Population Health Consulting relationship with all the Cerner Services leadership teams & the client
  • Generates value for the community and organization that promotes desired market positioning, credibility and sustainability
  • Continually synthesizes industry information, including trends, best practices and other information, to produce internal and external communiqués as well as create recommendations for clients
  • Knows corporate policies and holds engagement team accountable for modeling them, exhibiting the Leadership Dimensions and committing to personal development in the leadership domain
  • Works in accordance with corporate and organizational security policies and procedures; understands personal role in safeguarding corporate and client assets; takes appropriate action to prevent and report any compromises of security within scope of role
  • Understanding of managed care, payers and/or new models of risk and quality-oriented approaches to reimbursement are an advantage
  • Continuous tracking and understanding of industry trends and shifts related to population health
  • Demonstrated ability to develop business concepts and opportunities
  • Strong client advocate to support movement toward value based care
  • Key business development and/or operational experience with major healthcare organizations
  • Outstanding written and verbal communication skills, including presentation skills, potentially participating as a key contributor for publications and/or public speaking
  • Strong business and relationship building skills, organizational, problem solving and analytical skills, and strong written and verbal communication skills
  • Minimum of two (2) years of operational leadership experience
  • Ability to travel up to 50% nationwide (based on organization)
  • Minimum of seven (7) years Cerner, healthcare, and/or healthcare IT industry knowledge or Master’s degree in a healthcare or business related field
  • Minimum of four (4) years healthcare industry experience
  • Performed in at least one (1) senior management role
  • Regulatory and payment reform experience
  • Prior consulting, project management, and/or installed client relationship experience
52

Population Health Datainsights Data Analyst Resume Examples & Samples

  • Familiarity with healthcare market
  • Proficient computer skills, including Microsoft Excel, SQL, R, Business Objects, Tableau, etc
  • Experience processing and manipulating data and recognizing trends and anomalies
  • Ability to communicate with internal and external stakeholders
  • Ability to deal with ambiguity and propose improvements
  • Recommend efficiencies by automating and standardizing key business processes
  • Must be self-motivated to identify and solve problems
  • Bachelor's degree in a related field or equivalent work experience
  • Experience with data analysis and SQL
  • Must currently reside in or be willing to relocate to the Kansas City area
  • Ability to travel up to 10% as required
53

Population Health Resume Examples & Samples

  • Responsible for the definition and maintenance of the standards of project management and process
  • Maintain and update the project management framework and disciplines necessary to support a PMO
  • Prepare status reports
  • Record amount of time spent on project work and estimates to complete to evaluate project status and budget. Continuously update and evaluate relevant project metrics i.e. ECAC, schedule variance, etcetera, and associated impacts (positive/negative) to project plan. Dynamically updates project plan based on evaluation of metrics, with frequent communications of deviations to relevant project stakeholders
  • Maintain processes to ensure project management documentation, reports and plans are relevant, accurate and complete
  • Assist and advise project sponsors, internal managers, project steering committee and external partners, and teams to the best use of project management disciplines and approaches within a fast-paced, high tech environment
  • Develop positive relationships with project sponsors, internal managers, project steering committee and external partners, and teams to enable the PMO to provide support including facilitation, tracking and reporting on projects
  • Assist with establishing PMO stakeholder management plan and implementation of the communication framework
  • Act as a reference point for PMO queries and information and an advocate for best practices in project management
  • Share lessons learned and best practices across programs, building relationships with stakeholders and brokering relationships at all levels
  • Understand the deliverables of internal and external PMO stakeholders and contribute to success through cooperative and collegial processes
  • Contributes to the flow of communication within the team, by actively participating in team meetings
  • Creates and manages change management process
  • LI-MKM
54

Supervisor, Population Health Resume Examples & Samples

  • Minimum of 1 year supervisor experience preferred
  • Experience with healthcare deliver required
  • Experience with population health, tele-management or ambulatory care preferred
  • Experience with remote workforce preferred
  • Ability to work in a fast paced ever changing environment
  • Ability to make generalizations, evaluations and decisions without immediate supervision
  • Ability to prioritize and assign large volumes of work to an interprofessional team
  • Self-motivated to keep up to date with current standards of care and treatment modalities
  • Ability to lead change and mange projects
  • Strong customer service skills with focus on service recovery and ability to manage complex issues
  • Superior computer skills-proficient with EHR, Microsoft Office products
  • Ability to prioritize and manage multiple assignments simultaneously
  • Ability to problem-solve in an effective and timely manner
  • Excellent management skills relating to staff development, operational effectiveness, HR management and staff retention
  • Ability to manage issues, but recognizes when to escalate
55

Healthcare Director Business Process Improvement Population Health Resume Examples & Samples

  • Develops short term and long term strategies along with programs to drive continuous improvement culture for a sustainable long term benefit. Determines the optimal approach in leveraging continuous improvement methodologies
  • Works with DS management team, and other department heads to develop and implement performance metrics for core work processes and define continuous improvement performance targets
  • Tracks and validates all improvements and dollar savings (P&L, balance sheet, cost avoidance) attributed to optimization programs
  • Ensure all resources, processes, tools, and guidelines are optimally aligned to meet the strategy and goals of the Digital Services organization with a focus on ensuring the highest levels of customer focus and customer excellence
  • Ensure all processes adhere to corporate compliance guidelines as well as all applicable state and federal mandates regarding equipment safety and documentation of all customer employee interactions
  • Provide leadership and coaching to support an engaged, high performing culture
  • Acts independently to determine methods and procedures on new or special assignments
  • Assembles and directs cross functional/cross site project team(s), including information compilation and information flow
  • Works on abstract problems across functional areas of the business. Identifies and evaluates issues for major functional areas through assessment of intangible variables
  • Fosters a sense of urgency and champions radical change that pushes for continual improvement with a focus on improving efficiency, quality and driving down costs
  • Develop mechanisms to meet and exceed budget and revenue goals and attainment of all targets and metrics established by the DS Head to meet strategic direction and goals
  • Exhibit the highest levels of leadership and guidance to develop an expectation and culture of cooperation, teamwork and customer excellence with all levels of the Digital Services organization
  • Maintain highest levels of accountability and responsibility for development of staff and provide appropriate disciplinary responsibility for their teams
  • 8-10 years working in a continuous improvement role with proven track record of transforming behaviors and subsequently a culture to a continuous improvement organization
  • Lean Six Sigma experience is a plus
  • Prior experience in a large distributed workforce with a matrixed environment
  • Tertiary degree in a technical, management and/or commerce discipline; technical understanding a pre-requisite
  • Communication capability, organizational capability, presentation capability
  • Professional experience in a service business in a relevant industry
  • Experience in managing, leading and motivating teams and individuals
  • Sensitive towards and experience with multinational companies, clients and people
  • Ability to interact with and network with Senior Executives
  • Ability to priorities work taking into account a complex matrix of inputs
56

Supervisor, Population Health Specialists Resume Examples & Samples

  • Supervisory Duties Provide clear direction for staff by establishing goals, objectives, policies, procedures, performance improvement programs, and action plans as needed. Performs training, coaching, and auditing. Participates in hiring of new staff
  • Manages operations and productivity within the established guidelines. As a member of the management team, participates in the development of goals, objectives and tactical plans consistent with the organizational strategic plan and vision
  • Actively and continuously analyzes workflows, organizational structure, staffing assignments or other factors to ensure optimal performance; makes recommendations and modifications, as necessary
  • Focus on continuous improvement. Changes departmental practices/processes to meet changing needs of the business. Monitors and audits staff individual tracking and reporting to maintain quality of work and accuracy of reporting. Identify discrepancies, develop solutions and initiate corrective action plans when necessary
  • Participate in Population Health Leadership team meetings
  • Demonstrates, after receipt of training, mastery of all applicable electronic systems/applications including but not limited to the Patient Registry, Electronic Health Record (EHR) and population management systems
  • Experience in either medical practice management, managed care provider relations, or hospital physician management operations
  • Experience supervising and mentoring staff a plus
  • Demonstrates ability to apply principles of critical thinking
  • Ability to prioritize multiple tasks
  • Excellent interpersonal and communication skills, including customer service skills
  • Has a basic understanding of management of chronic health conditions and population management and is able to communicate those concepts to staff
  • Able to do analysis and audit quality measure reporting
  • Ability to identify, document and standardize work flows
57

Associate Regional Director Population Health Resume Examples & Samples

  • Leadership of ongoing operations, including direct management of a team regional Clinical Transformation Consultants
  • Optimization of program operation by developing processes for operational and clinical use
  • Develop and execute resource plans
  • Coordinate development of infrastructure around people, process, and technology to achieve scale, working in a matrix environment
  • Design and develop clinical and analytical capabilities that will enable the Clinical Team, working closely with Medical Directors and clinical resources as well as with key stakeholders in Network (UHN), Healthcare Economics (HCE), or State / Regional Market leaders
  • Drive execution of ACO Clinical expansion plan by overseeing timely and successful deployment at new sites and ongoing practice engagement, working closely with a clinical front office as well as a regional Network stakeholders
  • Lead a team of cross-functional members with operations and business analysis capabilities
  • BA / BS required; MBA or a Master's degree in Public Health Administration, Public Policy, Economics, or related fields Highly Preferred
  • 2+ years Population Health and/or Healthcare Transformation experience
  • 3+ years working with health systems on performance improvement and/or increasing efficiency
  • 8+ years of work experience which includes experience in cross-functional business areas such as general management, strategic planning, business development, project management and people management
  • 3+ years of managing remote field based employees
  • 25% Travel Required
  • Critical thinker-this position will need to evaluate merits of new and innovative ideas and make sound decisions
  • Strong influencer- this position will partner with Clinical resources to enable practice transformation
  • Strong relationships-this role will work with Clinical Consulting Directors, Medical Directors, Sr. Leadership as well as business and technology partners to plan, direct and develop clinical programs
  • Strong Communicator-this role will need to be extremely comfortable presenting program objectives, scope, and process across segments
  • Works effectively in an ambiguous environment
58

Executive Director of Population Health Resume Examples & Samples

  • Bachelors of Science in a Health and Wellness related field such as health promotion, human services or exercise physiology
  • Strong interpersonal skills, including communication (written and verbal), decision-making and conflict resolution
  • Knowledge of healthcare systems, marketplaces and EMR platforms
  • Previous experience working with people in an exercise setting, preferred
  • Must have the ability to build strong relationships, inspire confidence, and work with diverse populations
  • Perform quality work within given deadlines and expectations with or without direct supervision
  • Interact professionally with other employees, members, program participants, volunteers, and other individuals within the community, always being mindful of the YMCA’s four core values of caring, honesty, respect, and responsibility
  • Serve effectively as a team contributor on all assignments
  • Work independently while understanding the necessity for communicating and coordinating work efforts with other appropriate individuals
  • Provide support and supervision to population health staff members including but not limited to district managers/directors, Data Director, healthy aging and nutrition staff
  • Complete all required trainings/meetings to maintain compliance with association, YUSA, CDC and other relevant policies/priorities of partner organizations
  • Build capacity of and deliver population health programs in a manner that complies with and or exceeds published standards of the CDC, YUSA and other applicable organizations
  • Ensure staff conducts intake interviews (using Listen First skills) to learn about interested participants, assess their readiness prior to enrolling them in an upcoming class
  • Work with center executives, healthy living directors and community partners to ensure that all resources necessary to achieving program goals are available. This includes but is not limited to intake space, classroom space, work station and relevant materials that facilitate compliance with HIPAA regulations, comprehensive class schedule and provider communication system
  • Ensure that each participant that begins a program is set up with a Coaching Connection appointment with a Healthy Living Coach to assign a basic cardio and strength training program based on their ability and physician’s recommendations
  • Ensure the Director of Data Management is tracking all of the applicable data points for each participant within the population health portfolio. Do this in a manner that allows aggregate data to be provided to employers, physician groups, IRB and other partners in the community
  • Work with your team and center staff to develop and implement an effective way to manage waiting lists and the flow of referrals and outcomes to physician groups
  • Serve as a liaison between the YMCA and community partners within our entire service area. Paying special attention to medical providers, health departments and like-minded community based organizations
  • Pursue further clinical integration of YMCA population health programs into care process models throughout our region
  • Identify and recruit employers and insurance providers to reimburse and/or pay for their employee’s participation in our evidence-based interventions
  • Align Population Health sales and development strategies with those of the Marketing and Communications and Membership Departments
  • Work with Healthy Living Directors to train, evaluate, and retain quality Healthy Living Coaches, GEX Instructors and program coordinators who will help serve as resources for cross-pollination of participants within YMCA facilities
  • Ensure all administrative duties associated with the programs are handled in a timely and professional manner, including maintaining program materials, serving as a Lifestyle Coach as needed, and quality assurance (monitoring and assessing the results of our programs as well as assuring program fidelity)
  • Understand and enforce all program standards and procedures at all times
  • When in the program location with participants, establish positive relationships with them, encourage their progress, enforce center policies, alleviate potential safety hazards, correct form, etc
  • Assist as needed in emergency situations and as outlined in emergency procedures
  • Develop annual budget and manage your programs so that they operate within established fiscal boundaries
  • Attend and participate in all meetings, program development activities, YMCA events and healthy living program initiatives
  • Be a team player; maintain a positive and supportive attitude to all center staff and members
  • Display a professional, courteous, and tactful demeanor at all times
  • Share knowledge of programs, events, and resources with members throughout the facility and in the community when representing the YMCA of WNC
  • Initiate communications with your supervisor and Healthy Living staff as necessary concerning program problems, personnel conflicts, and member concerns
  • Work with Financial Development to identify and pursue grant opportunities, relay program outcomes and provide case statements about program and community impact
  • Maintain detailed program outcomes and assist with the completion of all grant reporting requirements. Stay vigilant in the pursuit of additional grant funds to ensure program sustainability
  • Work to further our efforts around nutrition by developing programs within our centers designed to educate our members and the community at-large. Leverage existing resources to ensure that nutrition programming drives revenue production as well as community impact
  • Ensure that center operations support our commitment to the healthy aging population. This includes but is not limited to vitality based onboarding and programs, facility layout, volunteer opportunities and customer service
  • Remain vigilant surrounding future growth opportunities while ensuring that all new efforts align with community needs and YMCA strategic priorities
  • Serve as the primary authority for maintaining high-quality program outcomes that meet and/or exceed those described in our grant narratives
  • Assist association leadership with establishing a healthy workplace culture that embodies the YMCA mission and our role in the community
  • Serve as the primary point of contact for all population health interventions for our association
  • Assist with Annual Support Campaign as assigned
  • Responsible for other opportunities as assigned by the Chief Operating Officer
  • Come to work on time and adhere to dress expectations according to dress guidelines, (name tag, specified staff shirt, no torn, ripped or dirty clothing, shorts must be knee-length)
  • Attend all required department, leadership and all-staff meetings
  • Work collaboratively with the membership department to ensure member satisfaction, conversion and retention
  • Refrain from diagnosing injuries, offering medical advice, and dispensing or endorsing any and all commercial health products especially nutritional supplements, vitamins, performance enhancing substances, and pain relievers
59

Population Health Integration Architect Resume Examples & Samples

  • Ability to work flexible schedule as necessary
  • Bachelor's degree in CIS, MIS, IS, Computer Science, Engineering, or Business Administration with emphasis in information systems or equivalent work experience
  • 3 years’ experience with systems, systems management, or related experience
  • Previous experience with HL7 or data integration
  • Must reside in or be willing to relocate to the Stony Brook, NY area or willing to travel at least 12 times per year on a schedule agreed upon by the client
  • Bachelor’s degree in Healthcare, Statistics, Economics, Computer Science, or an advanced degree in a comparable program with a quantitative emphasis and 3 years relevant experience in Ambulatory Care, Home Health or Case Management and advanced knowledge of healthcare data and the healthcare industry
  • Knowledge of, and exposure to, established standards of care presented by CMS, NCQA, AHRQ, IOM, The Joint Commission and various healthcare associations
  • Experience with Cerner Millennium
  • Experience in dashboard development and support
  • Experience with X12
  • Previous experience with CCL, SQL or comparable database language
  • Previous programming experience
60

Population Health Client Executive Resume Examples & Samples

  • Excellent written and verbal communication skill
  • Proficient with Microsoft applications
  • Understanding of sales and marketing processes and approach
  • Self-motivated and ability to multi-task and the ability to work independently, needing minimum direction
  • Able to work overtime as needed
  • Must currently reside in or be willing to relocate to the Northwest portion of the US
  • 3+ years’ experience selling integrated healthcare solutions or successful completion of Cerner’s Client Representative training program
  • Healthcare and Population Health industry knowledge
  • Experience selling and or presenting in a clinical environment
  • Skills or experiences with performance improvement methodologies (Lean, Six Sigma, TQM)
  • Basic Knowledge of the At-Risk/Value-Based Contracting between HealthPlans and Health Systems
  • Familiarity with Federal, State, and Local Government Care Delivery Transformation Legislation/Waivers
61

Head of Pqms-population Health Management Resume Examples & Samples

  • Ensures compliant and effective QMS’s within Population Health Management BG are maintained in scope
  • Accountable to manage and harmonize all QMS management processes and ensure FDA-compliant validation of all Software systems in scope
  • Ensures Q&R requirements are effective in all processes in scope
  • Ensures Document Control is established and ensures training profiles are assigned and enforced and training administration is established within scope
  • Facilitate Corrective Action and Preventive Action efforts as necessary
62

Population Health Resume Examples & Samples

  • Serve as client contact, responsible for maintaining excellent relationship with client management
  • Understand client pressure points and appropriately prioritize and escalate issues within the team
  • Maintain a clear definition of client’s responsibilities and athenahealth’s responsibilities with each engagement
  • Provide guidance to the client’s management team in development of best practices documentation and content modification/creation of report and dashboard templates
  • Design and modify existing dashboards and reports and other content as appropriate, and work collaboratively with colleagues on configurations and modifications that would optimize the client experience
  • Provide training to the client’s analytics team and provider and care management teams when applicable
  • Work with client’s analytics team to refine additional training for practice and other client staff
  • Work with the product innovation staff to design, test and implement new reports, customizations and functionality
  • Excellent client-facing skills with clients and the ability to champion the cause of the client and serve as an athenahealth advocate
  • Strong research, problem-solving, and analytical skills
  • Strong computer literacy and the comfort, ability and desire to further advance technically. SQL a plus
  • Understanding of healthcare claim data and value based contracts
  • Ability to develop professional and effective working relationships with clients and colleagues
  • Demonstrates flexibility & adaptability when approaching project portfolio
  • Presents questions, findings, and resolutions both verbally and written in an articulate and organized manner
  • Carries themselves in a professional manner
  • Manages timelines and expectations when working internally & externally
  • Facilitation of a friendly and collaborative work environment
  • Understanding business need over individual goals
  • Shares process & product knowledge with peers and clients in an organized and clear manner
  • Proactively works to decrease knowledge gaps with process and functionality
  • Takes ownership and direction in learning and self-development
  • Responds well & incorporates industry and business change into daily functions
  • Experience in a health care setting preferred but not required
  • Proficient in Microsoft Office Suite
  • 1-4 years of work experience in a professional environment
  • Enthusiastic about joining the healthcare industry
63

Rn-population Health Days Resume Examples & Samples

  • Minimum of five years of experience in healthcare setting required, preferably ambulatory. Case management and care management experience preferred
  • Strong Microsoft office suite software knowledge required
  • Knowledge of performance improvement, billing, coding, and documentation requirements highly desired
  • Knowledge of evidence-based behavioral change methodologies and motivational coaching techniques
  • Excellent interpersonal, communication and writing skills are essential with the ability to relate and motivate effectively with a diverse group of patients and clinical staff
  • Quality Evidence-based Medicine
64

Population Health Information Analyst Undergraduate Intern Resume Examples & Samples

  • Data extraction (SQL, SAS)
  • Applied experimental design/project improvement
  • Data analysis (EXCEL, SAS)
  • Information sharing through graphics and documentation
65

Manager, Total Population Health Resume Examples & Samples

  • Leads and mentors staff to understand disease management and complex case management concepts and effectively apply the concepts to managing members with chronic health conditions
  • Continuously assesses process effectiveness and implements changes to maximize efficiencies and quality of care while minimizing costs, increasing productivity in accordance with applicable regulatory requirements
  • Monitors and improves program effectiveness and assures that the output is closely linked to benefit plan provisions, regulatory compliance, accurate claims adjudication and the strategic goals of Healthcare Management
  • Acts as a coach and mentor for staff to ensure continual staff development and to assist with the resolution of employee performance issues
  • Performs other duties and projects as assigned
  • At least 10 years of clinical and managed care experience
  • State of the art knowledge of utilization and case management tactics
  • Strong oral and written communication and interpersonal skills
  • Previous system user experience in a highly automated environment
66

Population Health Data Senior Associate Resume Examples & Samples

  • 40% Data Maintenance
  • Support seamless flow of data from source to the front-end application, helping newer or more junior team members to do the same
  • Leverage and build test plans and metrics to validate success of the team’s work; owning those projects with more complexity or with product knowledge needed
  • Act as go-to resource for analysis and in-depth understanding of source data
  • Act as day-to-day mentor to newer or more junior team members
  • 30% Process Improvement/Scalability
  • Contribute to optimization and automation of standard processes
  • Enhance and optimize code base to improve scalability and performance
  • Assist Managers in implementing new processes or internal team efforts that will improve the efficiency and productivity of the team overall
  • 25% Relationship Management
  • Proactively research and resolve data issues that impact client success
  • Collaborate with internal teams to improve the data integration system
  • Provide support and guidance to cross-functional teams a technical resource
  • Mentor newer or junior team members to increase their effectiveness in working with stakeholders and internal peers
  • 5% Special Projects
  • Assist with ad-hoc data operations needs and cross-functional projects within Population Health
  • 2+ years of professional experience with relational databases – writing queries and managing data; SQL programming experience preferred
  • Understanding of data management tools and analysis techniques
  • Understanding of healthcare data and value-based contracts preferred
  • Experience in analyzing complex business problems
  • Knowledge and understanding of athenahealth product suite and business model preferred
  • Adaptability and comfort with ambiguity as we grow offerings with diverse requirements, stakeholders, and opportunities – and sometimes with constrained resources
  • Ability to communicate effectively with internal and external stakeholders at various cohort levels
  • Ability to independently prioritize, drive results, and meet deadlines
  • Ability to dive deep into information and articulate core findings to the broader group
  • Able to expresses complex issues succinctly and logically
  • Able to execute multiple project work streams simultaneously and transparently, ensuring that all internal and external stakeholders understand the projects’ goals and deliverables
67

Coord Population Health Resume Examples & Samples

  • Conduct out-bound calls to patients to schedule appointments at the clinic, offer and schedule pre-visits with the health coach
  • Conduct out-bound calls to Senior Care patients who have no-shown follow up or annual visits with PCP
  • Conduct out-bound calls to Senior Care patients who have had recent ER visits to provide education on 24/7 availability
  • Conduct out-bound calls to Senior Care patients who are currently experiencing gaps in care for quality measures
  • Complete timely data entry of contact information into software systems
  • Provide clerical or administrative support to clinical staff and managers for special studies, projects and reports
  • Maintains knowledge of health plan benefits, network, regulations, CMS and MSO policies
  • Schedule, prepare, lead and follow up on items from the PCC meetings for supported clinics
  • Serve as a point of contact for the centralized SNP team for care management
  • Train clinic staff on how to facilitate daily huddles to best prepare for Senior Care visits daily
  • Serve as primary point of contact for call center for Senior Care appointments to be worked into the schedule
  • Serve as back up for transition of care activities
  • Attend clinic specific rounds and meetings on patient care
  • Educate patients on available after-hours care options
  • Document all patient care activities into electronic database
  • Meet required Key Performance Indicators
  • Pass Quality Audit metrics
  • Coordinate and cooperate with other members of the care management team
68

System Analyst, Population Health Resume Examples & Samples

  • Excellent interpersonal skills required for day-to-day interaction with entity clinical department management
  • Specific clinical knowledge and experience that will enable the self-confidence to carry out responsibilities and interaction with co workers in a professional manner
  • Willingness to travel from entity to entity
  • Willingness to attend training classes- out of state requiring overnight travel over multiple days
  • Environment is subject to high-level visibility through verbal and written communications with senior hospital management, associated project deadlines
  • Ability to exercise independent judgment and maintain confidentiality of material and information
  • Ability to function effectively in a fast paced environment and meet goals of timeliness and quality
  • Must be available for on-call support on a regular basis. Due to project requirements, overtime will be required as needed
  • Must have a Bachelors and at least 3 years experience in a progressive IT role
  • Working knowledge of policies, procedures, and business operations
  • Proficient in Microsoft office, Microsoft Project, Visio
  • Demonstrated ability to manage to deadlines, changing priorities
  • Strong project management skills (ability to lead meetings, prioritize, resolve conflicts, maintain issues list, manage project plan)
  • Strong communication and follow-up skills
  • Detail oriented and knack for probing for information in order to fully understand the underlying needs that drive how the system should be built
  • Strong problem-solving abilities; excellent communication and interpersonal skills. Independent and self-motivated, energetic with strong desire to learn
  • Must be Epic certified in an existing Epic clinical application. Ambulatory Preferred or attend and complete Epic certification requires 1 week of out of state travel for course certification
69

Population Health Management Program Manager Resume Examples & Samples

  • Demonstrated relationship management skills with internal and external partners; strong client and consultant facing skills
  • Demonstrated program and project management: track record completing projects successfully
  • Demonstrated solution design experience: developing innovative clinical approaches to address the needs of a population
  • Supervisory experience: strong orientation to team work and employee development
  • Knowledge of Population Health Management
  • Strong background in program / project management
  • Strong interpersonal and relationship-building skills, with the ability to manage up, down and across levels of the organization including executives
  • Excellent interpersonal skills to communicate effectively with peers, administration and other internal/external stakeholders
  • Ability to work in a complex and matrixed team environment; experience working in a team-oriented, collaborative environment
  • Ability to create, manage, and enhance customer and vendor relationships
  • Highly self-motivated, self-directed, and attentive to detail. Ability to handle multiple tasks, set priorities, schedule, and meet deadlines
  • Knowledge of business operations
  • Ability to understand business strategy, operations, and IT projects and concepts as they relate to high-level business objectives, and ability to present those concepts to both IT and non-IT audiences in a concise and easily understandable manner
  • Identification with and support of the Mission and Values of Dignity Health and its Sponsors
70

Supervisor Population Health Case Management Resume Examples & Samples

  • Supervises staff
  • Hires/motivates, and evaluates a diverse group of healthcare professionals and technical/support staff to assure effectiveness of programs and appropriate professional evaluation of medical services
  • Monitors and maintains staff productivity and acts as a key resource to internal departments to maximize resource utilization (staff and equipment)
  • Provides and/or coordinates staff training for maximum performance and provides developmental opportunities
  • Monitors performance of staff and takes action if necessary to provide additional training or discipline as appropriate
  • Supervises attendance, behavior, vacation, etc
  • Promotes teamwork and positive working environment for staff
  • Responsible for communication to staff established criteria, policies, procedures & changes as they occur
  • Serve as a management representative for HCS at local meetings with providers, members and other community activities
  • Minimum of 2 years of supervisory experience
  • Minimum of 5 years health care experience
  • Prefer combination of 2-3 years of varied clinical experience in a health care management and disease management environment, i.e. Hospice, outpatient
  • 1-2 years Utilization Management or Case/Disease Management experience
  • CareAdvance and FACETS experience preferred
  • Travel to regional offices will be required
71

Population Health Program Coordinator Resume Examples & Samples

  • 2 years’ experience in healthcare or related field
  • Proficient in the use of computer applications, specifically Microsoft Office Products
  • Patient-Centered Medical Home (PCMH) experience, preferred
  • Team-building/facilitation of committees experience, preferred
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Director, Population Health Resume Examples & Samples

  • Demonstrated experience developing and implementing clinical, service, and operational process improvement initiatives, managing physician relationships, designing and using population health management resources
  • Current knowledge of regulatory requirements related to population health to ensure compliance
  • Knowledge of population health performance evaluation including financial performance, risk assessment, and intervention to improve outcomes
  • Ability to lead a team, manage resources and budgets for a department. Demonstrates a high degree of resilience, persistence and the ability to thrive in an environment of rapid change
  • Ability to organize, develop, implement, monitor and evaluate professional work plan goals and performance objectives. Must have superb organizational skills and attention to detail
  • Ability to lead, facilitate and work with diverse groups. Experienced in creating engaging, non-judgemental meeting environments that encourage sharing of challenges anf failures in supportive peer-to-peer learning
  • Ability to command respect, persuade, and obtain support to accomplish the vision. Demonstrated skills in group facilitation and communication, and establishing and managing objectives
  • Experience and proven ability to work effectively in a highly matrix organization
  • Demonstrated advanced communication, presentation, and organizational skills
  • Computer literacy with proficiency and expertise in Microsoft Office, including WORD, EXCEL, and Powerpoint
  • Has functioned in an ambulatory practice setting
  • Five years’ experience in a complex healthcare setting
  • Three years of leadership in a population health role with experience in (or closely working with) Operations and IT. Experience with Clinical IT platforms, and fluent with successful data analysis and interpretation
  • Staff in population health department
  • Community health workers
  • Collaborative relationships with practice RN’s
  • Active PA license as per clinical ex