Population Health Resume Samples

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V Effertz

Vanessa

Effertz

222 Jacquelyn Mission

Houston

+1 (555) 815 1398

222 Jacquelyn Mission

Houston

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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

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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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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.)

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

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)

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

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

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

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

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

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%

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 expertise

Product Manager, Population Health Resume Examples & Samples

3+ years of experience as a product of software development leader
3+ years in Healthcare Information Technology Industry
Superior analytical and quantitative skills
Experience using data and metrics to test theories, confirm assumptions, and measure success
Experience in business process management, lean startup, and agile / scrum methodologies
Experience in UI/UX design, and customer experience improvement
Deep expertise in market segmentation, product strategy, competitive strategy, and product development
Experience in the product lifecycle process or methodology
Ability to translate complex business goals into clearly understandable product strategy
Very strong interpersonal skills and demonstrated ability to work with teams inside and outside the organization
Outstanding verbal and written communication skills – both in the healthcare field as well as in the software and technology space. Concise, specific, logical, clear and understandable
Strong presentation skills, experience leading discussions and moderating validation sessions
MS Word, Powerpoint, Excel

Population Health Planning & Improvement Coordinator Resume Examples & Samples

Understanding community and population health as it relates to health-in-all policy and health equity
Ability to administer programs and initiatives such as strategic planning and CHA-CHIP
Ability to incorporate Continuous Quality Improvement (CQI) processes into program administration
Facilitating coalitions and strengthening community partnerships
Effective verbal and oral communication skills
Team building experience
Detailed oriented
Good time management skills
Knowledge and experience in the Public Health Accreditation process
Experience in social marketing
Masters in Public Health or Masters in Health Education
Experience in program management
Ability to lead and motivate others

Director Population Health Analytics Resume Examples & Samples

Strategic Decision-Making:Obtains information and identifies key issues and relationships relevant to achieving a long-range goal or vision; commits to a course of action to accomplish a long-range goal or vision after developing alternatives based on logical assumptions, facts, available resources, constraints, and organizational values
Patient Relations:Meets patient and patient family needs; takes responsibility for a patient’s safety, satisfaction, and clinical outcomes; uses appropriate interpersonal techniques to resolve difficult patient situations and regain patient confidence
Business Acumen:Uses economic, financial, market, and industry data to understand and improve clinic business results; uses one’s understanding of major business functions, industry trends, and DaVita Medical Group’s position to contribute to effective business strategies and tactics
Leadership Disposition:Demonstrates the traits, inclinations, and dispositions that characterize successful leaders; exhibits behavior styles that meet the demands of the leader role
Planning and Organizing:Establishes courses of action for self and others to ensure that work is completed efficiently
Develops and implements specific approaches for various types of medical services for Population Health cohort including: specialty referrals, ancillary services (laboratory, radiology, diagnostic procedures), outpatient surgeries and procedures, hospital, SNF and DME)
Coordinates and oversees a variety of complex projects to include but not limited to analyzing, forecasting, reporting and monitoring of financial and clinical information for Population Health cohort
Develop and conduct clinical and financial analyses for Population Health program performance reporting and decision-making. Compile and analyze data related to the Medicare Advantage HCC Risk Adjustment model, quality measures, medical claims payments and capitation contracts
Analyzes data by health plan, DaVita Medical Group service area, and service type to quickly identify trends and possible corrective action for problem areas related to the operations and finance for Population Health cohort
Interpret and analyze health plan contract terms related to Population Health cohort for payments to medical groups and hospitals. These include capitation, institutional and pharmacy risk pools, P4P, Medicare Star and similar quality incentive programs
Assists regional administration in identifying variation in practice patterns for Population Health cohort in their regions, developing interventions to reduce variation and monitoring the results of these interventions
Works with regional administration to identify variation in the way HCP delivers medical services (e.g., PCP vs. Specialist, in-house vs. contracted, FFS vs. sub-capitated) for Population Health cohort and performs analysis to compare the costs and outcomes of alternatives and to identify the best way of delivering these services
Develops and implements methods of evaluating outcomes and costs of any changes implemented in the delivery of services for Population Health cohort
Designs and implements evaluation studies for Population Health cohort to determine the comparative outcomes and costs of special programs implemented by the group to deliver medical services such as ambulatory care management, CHF or asthma
Develops recommendations to management concerning the cost-effectiveness of these programs and the potential for further implementation
Assures accuracy and timeliness of all analyses and reports for Population Health cohort
Performs research on published practice patterns and protocols, benchmark outcomes and costs for Population Health cohort
Required – Seven (7) years’ of relevant experience
Personal values in line with DaVita Medical Group’s values of service excellence, integrity, team, continuous improvement, accountability, fulfillment, and fun; Complete proficiency in Microsoft Excel, PowerPoint, and Access; VBA, SQL, and/or other programming skills required; Basic understanding of financial accounting and reporting; Demonstrated ability to collaborate with teammates on project inside and outside of the department; Experience with financial analysis, processes and terminology

Care Manager, Total Population Health Resume Examples & Samples

Act as the clinical coordinator collaborating with members, caregivers, providers, TPH multi-disciplinary team, and health care and community resources to evaluate member needs through a variety of assessments (care and utilization management) to identify areas of (medical, financial, environmental, health insurance benefit, psycho-social, caregiving) concern and potential gaps in care
Based on areas of concern, identify appropriate goals, strategies and interventions that may include referrals, authorizations, health education, activation of community based resources, life planning, or program/agency referrals
Work collaboratively with all stake holders to ensure knowledge of the action plan, including participation in telephonic and face-to-face case conferences when appropriate
Review and investigate member and provider requests to determine appropriate utilization of benefits and/or claim adjudication
Enter and maintain documentation in the TPH platform meeting defined timeframes and performance standards. Communicate authorization decisions and important benefit information to providers and members in accordance with applicable federal and state regulations, and NCQA and ConnectiCare standards
Identify quality, cost and efficiency trends and provide solution recommendations to Supervisor/Manager
Prior case management/care coordination and managed care experience preferred
Certification in care management preferred
Strong cross-group collaboration, teamwork, problem solving, and decision making skills

Population Health Management Technology Consultant Resume Examples & Samples

Experience with data extract, transform, and load (ETL) capabilities
Strong ability to utilize SQL to analyze data
Define and document customer business functions and processes (ICD and HLD)
Effectively communicate with developers (liaison between management and developers)
Strong connection and collaboration with various business areas
Displays a strong desire to create and contribute in a high performing development team
Work independently or with minimal assistance
Experience in SDLC processes
Strong Communication and Leadership skills
Ability to work in a fast paced, dynamic and changing environment while managing multiple projects simultaneously
Strong communication both written and verbal
Proficiency with the Microsoft Office Suite
Prefer etl knowledge with SSIS, Informatica PowerCenter / Data Transformation
Create basic SSIS projects
Knowledge of both T-SQL and PL/SQL
Create presentations when necessary
Display a strong desire to gain technical knowledge and skills by seeking out various learning opportunities
Understanding and experience with Development and Operations (DevOps) processes
Understanding of Population Health Management strategy to support Providers transition to the evolving health industry Value Based Care model
A Masters in Information Systems, Computer Science, or other Health IT discipline strongly preferred

Population Health Data Associate Resume Examples & Samples

40% - Implementation Execution
Assist team in executing client implementation projects, adapting the planned scope and enacting contingency solutions as needed to ensure of seamless flow of data from source to the front-end application
Accurately execute implementation plans with accuracy and efficiency to meet deadlines and meet goals/metrics
Act as go-to resource to both team and stakeholders via analysis and in-depth understanding of both processes and source data
35% - Process Improvement/Scalability
Contribute ideas and solutions that further optimization and automation of standard processes for implementation
Execute on enhancements to current implementation tools and processes - to help team improve scalability and performance
20% - Managing Relationships
Proactively research and suggest solutions to implementation or data issues to make an impact on successful process for client
Collaborate with internal teams to improve implementation account management hand-off cycle for clients
Offer support and guidance to cross-functional teams and technical resources
5% - Special Projects
Coordinate individual and team roles in ad-hoc data operations needs and cross-functional projects within Population Health
2+ years of professional experience with data integration and relational databases; SQL programming experience preferred
Knowledge of data management tools and analysis techniques
Familiarity with healthcare data of the following types: Clinical and/or Payor
Self-starter who can come up to speed on various technologies and methodologies with minimal training
Strong ability to independently drive results and meet deadlines
Adaptability and comfort with ambiguity as we grow offerings with diverse requirements, constituencies, and opportunities – and sometimes with constrained resources
Utilizes professional attitude and comfort working in a corporate setting populated by diverse types of people; able to maintain poise and a sense of humor in stressful situations
Proactive approach to identifying solutions to problems and to taking on work that helps collective team meet their goals
Ability to influence others through enthusiasm, commitment, and vision rather than direct line authority

Director of Finance, Population Health Resume Examples & Samples

Provide support to the Company’s Clinically Integrated Networks and to the Vice President, Population Health in the preparation of fiscal year budgets and month end close procedures
Supervise analysis of operating results on a monthly and quarterly basis
Monitors routine weekly, monthly, and quarterly reports for presentation to Group leadership and senior management
Assist in due diligence on potential acquisitions. This includes providing substantial input into the acquisition model and developing a transition plan post acquisition
Assist in the integration of new acquisitions in the LifePoint processes and month end close
Help to assure the integrity of the financial statements for the Population Health line of business
Integral in the monitoring and regulation of standardized chart of accounts and statistics

Program Manager, Population Health Management Resume Examples & Samples

Bachelor’s Degree in Health, Business or Financial Administration or related field, required. Master’s degree, preferred
Minimum of five (5) years healthcare industry related experience, required
Strong program management, interpersonal, communication, analytical and presentation skills, required

Population Health Medical Assistant Boise Resume Examples & Samples

High School Diploma or equivalent required. Graduate from an accredited Medical Assistant program required. MA credentialing from one of the following organizations is required to be completed within 90 days of start date
American Association of Medical Assistants (CMA)
American Medical Technologists (RMA)
National Healthcare Association (CCMA)
National Center for Competency Testing (NCMA)
3 years of previous clinical experience required; 5 years preferred
Customer service oriented attitude/behavior for both internal and external customers
Electronic health record (EHR) experience required. Demonstrated computer skills and ability to use applicable
Microsoft Office Suite including MS Excel applications
Experience with process improvement or Lean philosophy preferred
Ability to work independently or with a team to provide care to an assigned patient population under the direction of a provider, RN, or LPN

Population Health Performance Specialist Resume Examples & Samples

This person will be required to travel >80% of the time to a territory of Central/Eastern Pennsylvania and/or Delaware territory
Directly responsible for supporting providers contracted in the Organization's gain/risk share programs, with a goal of maximizing quality and ROI for the Organization. This includes analyzing performance reports and data to inform decision-making, process, and program implementation, as well as the development of process interventions based on practice-level data, trends and identified opportunities. Inclusive of, but not limited to: Advising primary care practices, physicians, nurses and other clinical staff to assist them on their conversion to value-based care; Dissemination and interpretation of quality and efficiency reports; When relevant, dissemination and support of gap closures for STARS and improved coding for government populations. Identification of process improvement gaps in workflow and development of individualized plans to remedy. Providing educational and training sessions. Creation and maintenance of relationships with specialists and/or hospital resources for providers employed in multi specialty groups or health systems
For value based contracts addressing government markets, directly responsible for the quality improvement and cost savings outcomes as a result of workflow transformation, superior coding accuracy, and Medicare STARS gap closure to providers based upon each individual gain/risk share contract parameters. This includes analysis and interpretation of claims submission for superior coding accuracy, cost and utilization reports, medical loss ratio reports, Medicare STARS gaps and other risk revenue opportunities
Function as the Organization's key contact on gain/risk share multi-disciplinary team. This includes presentation of program results to both internal and external audiences, including practice and entity meetings with the value-based reimbursement multi-disciplinary team
Participates in the development and presentation of instructional materials for internal and external audiences
Provides feedback to and collaborates with the analytics team to ensure reports are accurate, and provide meaningful, actionable data. Provide assistance to providers in the use of predictive analytic tools, user interfaces, population health management tools and other data based platforms endorsed by the Organization
Independently and autonomously manage gain/risk share contract caseloads, projects, meetings, deliverables, resources etc. for individualized strategic plans to ensure significant cost savings for provider contract holders using innovative continuous improvement methodologies. This includes cross training in all of Organization’s pay for value and value based reimbursement programs to lend support as needed/defined by market outcomes
Bachelor's Degree- Business, Finance or Healthcare related field
5 + years' experience in practice transformation including population health, ambulatory care setting quality and efficiency metrics, accountable care organization development and support, patient centered medical home, and electronic health records
Experience may be from either health plan or provider employers

Population Health Informatics Lead-careallies Resume Examples & Samples

BS or Master's degree or equivalent work experience
5+ years of work experience in a healthcare environment required
Familiarity with Medicare Advantage strongly preferred
Statistical analysis experience – required
SQL experience required
Understanding of healthcare and related STARs, HEDIS and HCC strongly preferred
Experience using query tools: SAS, Tableau preferred
Problem solving skills required
Analytical and data interpretation skills required
Excellent communication skills (written and oral) required
Solid interpersonal skills, including the ability to work closely with other team members and interact with business leaders

Senior Population Health Report Analyst Resume Examples & Samples

Contribute to analytics projects to support Presence Health initiatives and operations, with a primary scope including: 1) analytics required to support Presence’s population health contracts and initiatives; 2) analytics required to support the Presence Health business units (PHP, PMG, PLC, Behavioral Health, and System services) Secondary responsibilities include any other analytics required to support Presence Health initiatives and operations, such as analytic support for the Presence ministries
Take responsibility for the quality and accuracy of analytic products, including planning and execution of appropriate quality control processes
Understand analytic needs and requirements, and produce analytics that meet those needs/requirements
Understand and communicate analytic results effectively and appropriately to audiences with varied job functions and technical backgrounds, including recommendations, limitations and useful next steps
Provide technical and intellectual leadership in designing reports and analyses appropriate to business needs
Knowledge of statistics and statistical packages necessary to manipulate, analyze, infer and apply results of healthcare data, such as SAS
Expert knowledge of relational databases
Ability to effectively communicate analytic and reporting needs of the organization, including interpretation of results to health care leaders and other professionals
Ability to work effectively with various levels of management personnel, physicians, board members and other community members required
Positive and effective interpersonal written and verbal communication skills required
Ability to manage multiple priority projects simultaneously required
Ability to access, input, combine and retrieve information from multiple data sources required
Maintain and develop data expertise, business and industry knowledge and knowledge of relevant new developments in the industry
Bachelor’s degree in quantitative, scientific, business and/or healthcare fields required. Master’s degree in quantitative, scientific, business and/or healthcare fields, or Actuarial credentials, preferred
Requires at least 4 years of reporting and analysis experience which includes managing complex information systems, system implementation and support. Experience with healthcare informatics, oversight for computer programming, clinical quality measurement, and healthcare contract models (e.g., quality bonus programs, value based care) preferred
Experience with healthcare analytics and reporting (including advanced/statistical, clinical/quality, and financial/actuarial analytics) preferred
Experience using tools such as SAS or SQL to produce analytic/reporting results based on large and complex data (either hands-on experience or experience closely managing staff in these tasks) preferred
Experience working on analytics and reporting projects related to medical management, population health, health insurance, value-based care or clinical quality preferred
Required skills: using Microsoft Office suite of products, expert knowledge using Excel and/or Access as well as working knowledge using analytic/reporting tools such as Tableau, Visual Basic for Applications, SQL, SAS, R, Optum Impact Intelligence, Truven Advantage Suite, or other equivalent systems

Population Health Analyst Senior Resume Examples & Samples

Analyzes and interprets data to identify opportunities to improve cost and quality of care. Conducts analyses on cost and quality of care performance to facilitate medical and disease management and assessment of physician practice patterns. Perform internal review on data quality and reasonableness (compare historical performance with national, regional, and local sources) of reports and/or analyses of health services prior to external distribution. Participate in the development of policies and procedures related to the analysis, interpretation, and dissemination of health services data. Develop and recommend report formats and graphical representations of data. Develop and deliver written, graphical, and/or verbal presentations of provider, product, program, and service-specific data to internal staff, clinicians, UMHS leaders, relevant committees, and other constituencies
Work with database and business systems analysts to plan and implement the data management and analysis of major new products and programs (e.g. disease registries and reports), including definition of data requirements, data capture and storage, and analyses required to measure and evaluate performance. Coordinate with other team members and IT staff to determine timing of development efforts and key milestones. Participates in all activities related to data quality, integrity, analysis, and reporting
Works with clinicians and administrators to develop strategies to improve performance. Participates on UMHS quality improvement committees as needed
Aid in mentoring and training of new and/or junior staff on data analysis and related processes. Provides functional supervision of students as needed to ensure task completion and product delivery in efforts to measure quality and improve performance
Other duties as assigned by Supervisor
Bachelor's or Master's degree in health care field or equivalent experience

Population Health Documentation Developer Resume Examples & Samples

Outstanding communication skills; written and verbal
Ability to work overtime and irregular hours when needed
Ability to learn and apply new technical skills and concepts quickly
Bachelor’s Degree in Technical Communication, English, or related area or equivalent work experience
Must be currently residing in or willing to relocate to Kansas City, MO
Understanding of software development processes and tools and previous work experience as a technical writer
Ability to demonstrate high-quality writing through a portfolio of your work
Clinical or technical experience

Population Health Claims Auditor Resume Examples & Samples

Gather information to review, analyze and accurately audit claims.20%
Reviews claims (CMS 1500 and UB04) for accuracy of claim determination following CMS criteria.10%
Performs routine and moderately complex audits on individual, random and focused claims to identify exceptions to established claims adjudication requirements.30%
Communicates to the department when a problem has been identified.5%
Works as a team player and communicates in a positive manner with members, providers, co-workers, managers and other contacts.5%
Effectively develops organizational capabilities.5%
Prepares and distributes reports, summarizes findings and recommendations.5%
Prioritizes and manages individual workflow as needed.5%
Claims auditor performs pre-payment and retrospective audits to verify the payment accurately reflects the contracts while meeting or exceeding individual accuracy, production and timely auditing objectives.10%
Must cross-train in the auditing of all networks.5%
Performs all other duties may be assigned as needed
3 years experience in medical/institutional claims processing within an IPA/Medical Group setting
Familiarity with computerized claims processing/transaction system and medical code (CPT and ICD9/ICD10)
Familiarity with medical/hospital coding (CPT, ICD-9/ICD-10, ASA) and standard billing formats (CMS 1500, UB04). Comprehensive knowledge of claims reimbursement methodology
Be able to work effectively under pressure
Possess strong analytical and problem solving skills
Requires good written and verbal communication skills to communicate effectively
Possess a high level of flexibility and attention to detail
Must be able to work as a team player and have a professional demeanor

Population Health Analyst Resume Examples & Samples

Responds promptly and appropriately to customer questions/concerns/complaints and attempts immediate resolution
Keeps customer’s information confidential, including public places such as elevators or the cafeteria
Provides assistance and offers help immediately, including finding someone else to meet the request, if unable to do so him/herself. Introduce other staff to customers when a hand-off occurs and explain that the person will provide excellent service

Clinical Director Population Health Resume Examples & Samples

Responsible for directing clinical operations for the Population Health, Care Management and Social Work functions for Summit Medical Group, and for Summit Health Management clients
The Clinical Director is also responsible for the overall planning, programs, vision and strategy for Clinical Population Health aligned with the SHM senior management objectives
The position has oversight for interdisciplinary roles within the department including Care Management, Care Navigators, Social Workers, Population Health Outreach, Patient Engagement and related analytics

Data Analyst, Population Health, Days Resume Examples & Samples

Minimum of two years in hospital data management or in physician practice management
Well-versed in multiple clinic EMR platforms. Preference for: eClinical Works, Epic, Athena, Meditech, Allscripts, Greenway, and GEMMS
Experience with state and payer-based data sources, such as Arkansas SHARE (Health Information Exchange) and AHIN (Advanced Health Information Network)
Solid understanding of the business and financial considerations of a healthcare organization, including but not limited to, excellent analytical skills, data aggregation, analysis, interpretation, and application

Navigator, Total Population Health Resume Examples & Samples

Works collaboratively, as a critical component of the multi-disciplinary team, to facilitate all TPH processes and activities
Complete outreach to defined populations for the purpose of TPH program introduction, authorization processing/communication, health screening, environment/safety assessment, functional assessment, health coaching and/or triage
May perform a wide range of research and educational outreach activities to encourage healthy behaviors, such as outreaching to identified members who need a primary care provider or who may have gaps in care related to recommended tests or provider visits, and facilitate gap closure and receipt of evidence based care
Coordinate directly with faith based organizations, community agencies, and other locally based organizations to identify available and/or alternative resources for a wide range of concerns, including home safety, financial assistance, caregiver support, transition assistance, and transportation
Conduct pre-, concurrent, and post-service review activities in support of clinical staff responsible for determinations, including management of benefit exclusion determinations, in accordance with departmental policies
Researches and resolves claim and authorization discrepancies/issues to facilitate timely and accurate claims adjudication in compliance with company policy and regulatory requirements
Demonstrates excellent problem solving and decision making skills in referring cases to a TPH Care Manager for any questions related to their clinical status, treatment plan, treatment options, authorization status or other clinical issues or to other members of the care team based on need of member
Actively participates on assigned committees and projects
Associate’s degree or an equivalent combination of education and experience in population health, care management and/or utilization management, health promotion/coaching/outreach and/or wellness education
At least 5 years of experience in a managed care setting having familiarity with benefit plans for multiple lines of business, authorization processes and concepts of medical cost management
Experience associated with discharge planning, care transition interventions, standard quality measures and prior authorization is preferred
Strong knowledge of medical terminology, ICD and CPT coding required
Knowledge of community health, social service agencies and other community resources is preferred
Strong oral and written communication, organizational, analytical and interpersonal skills required. Trained in the use of Motivational Interviewing techniques a plus
Smoking Cessation certification preferred

Care Manager, Total Population Health Resume Examples & Samples

Prior case and/or utilization management/care coordination and managed care experience preferred
Certification in utilization or care management preferred
This position is an in the office role, and not work at home

Head of Q&r-population Health Management Resume Examples & Samples

Must have leadership experience in various aspects of Q&R (including internal and external representation on Q&R) AND preferably in at least one operating process domain (Product development, Supply chain, etc.)
Must be experienced in establishing Q&R strategy, oversight, Quality system etc., preferably at group/corporate level in a large multinational company
At least 18 years of industry experience, from a highly regulated environment of Automotive, Aerospace, etc
Must be familiar with business process management framework including industry practices, such as APQC
Relevant training, experience, and certification in Continuous Improvement practices such as Lean/Six Sigma highly preferred
Master’s Degree in technical or scientific field of study (e.g., biology, biochemistry, etc.) or comparable professional industry experience

Population Health Prgm Coord Resume Examples & Samples

Responsible for reporting, data collection and information distribution on projects integral to sustaining QI initiatives, payer programs, NCQA level 3 status, care management, & population management initiatives
Manages disease-based dashboards and registries
Identifies care gaps in collaboration with the Population Health Director
Coordinate strategic efforts in addressing the population health care gaps
Works with data analyst to run reports on chronic disease management metrics, utilization
Works with data analyst to maintain and develop monthly reports of key elements needed for the projects and feedback to the practice on progress
Coordinate process improvement projects and provide implementation support to care teams
Provide project management support to the Medical Director & Population Health Director
Responsible for project coordination associated with CPC+ under the direction of the Director of Practice Operations and the practice leadership team
Reviews and completes reports for city, state and federal agencies, including payers under the direction of the Director of Practice Operations
Completes and submits monthly reports

Population Health Engagement Controller Resume Examples & Samples

Reviews project work plans and coordinates management of individual project progress against overall project work plan
Helps develop, analyze, and execute budgets that allocate resources and estimate financial requirements
Maintains overall project schedule – identifies interdependencies, risk area overlaps, etc
Supports and maintains applicable reports associated with the engagement
Monitors all key financial metrics to ensure funds and resources are allocated appropriately
Reviews project issues lists and highlights major issues, resolution and due dates for issues impacting the overall project
Moderates project status meetings with client and project team
Monitors scope discrepancies and drives to resolution on behalf of the project team
Reviews, approves and follows up on exceptions on timesheets and expenses
Reviews and resolves any expense issues with Engagement Management
Understands Revenue practices and how it is applied in contract
Reviews, understands and is knowledgeable source on all contract terms and conditions
Prepares contract change document or arrangement letter to reflect scope changes
Reviews Arrangement Letters relative to pricing models, contract, etc
Participates in ongoing sales activities
Understands consulting tools and processes to effectively support Engagement Management team
Performs other responsibilities as needed
Ability to communicate across levels, internal and external
Strong team player and relationship builder
Strong computer skills, including Microsoft Office suite
Must reside in the Kansas City metropolitan area
2+ years project management experience
1+ year of financial experience is preferred
Prior experience working with a Project Management Office (PMO)

RN Manager, Total Population Health Resume Examples & Samples

In conjunction with others, is responsible for the execution of efficient departmental processes designed to manage inpatient and outpatient utilization and quality of care within the benefit plan
Contributes to the overall success of Total Population Health by promoting /advancing the department mission of effectively facilitating care and improving outcomes at all points along the health care continuum, from preventive health and wellness through chronic care management to end of life care
In partnership with the Manager, Clinical Compliance assures that work processes are documented and measured in accordance with applicable Federal, and State regulations, NCQA standards, and ConnectiCare business requirements
Establishes effective process controls and compliance indicators of critical performance points
Mentors staff and assures that staff has appropriate knowledge and training. Represents Medical Operations on cross-functional teams to ensure alignment of efficient processes. Leads and develops team to quickly assess and diagnose root causes to problem areas
RN, licensed in Connecticut. Bachelor’s Degree in Nursing, health care, or business, or an equivalent combination of education and experience
At least 5 years of successful previous managerial experience with ability to work in a matrix management environment
Competence in quality improvement and data interpretation

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