Co-lead the development of Population care with PacificSource members and Legacy Health in: disease management, complex care management, utilization support, health promotion, new care paths. Understand best practice and evolving practices in Primary care, behavioral health and Specialty care. Take the learnings from the work with Legacy and implement Population Health programs with other Preferred groups in key geographical locations in all states we reside in.
Work Experience: At least 5 years’ experience in an executive healthcare or public health role with varied clinical focus, quality focus and plan knowledge. Experience and understanding of NCQA or URAQ standards. Understanding of CMS, federal/state regulations. Experience in system design, strategic planning in health care operations.
Education: Health Care professional such as MD, DO, RN, MSW. Bachelors’ degree required and Master’s level in Health care or other relevant field preferred.
Knowledge: Knowledge and understanding of disease prevention, medical procedures, diagnoses, care modalities, procedure codes, including ICD-9 & 10 CPT Codes, health insurance and state mandated benefits. Ability to develop, review, and evaluate utilization reports. Knowledge of quality improvement methodology. Knowledge of principles of adult learning and/or motivational interviewing. Experience giving presentations. Good organizational skills with experience in using computers and various software applications including Word, Excel, PowerPoint, Outlook, SharePoint, and audio-visual equipment. Ability to work independently with minimal supervision.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 15% of the time.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.