This role receives direct supervision from the Director of Clinical Operations and Transformation and helps to support the operation of the clinical operations division. The role will serve as a critical liaison between multiple departments within the clinical operations division, fostering collaborative efforts to enhance operational efficiency and improve health outcomes for our members.
This role cross functionally supports all clinical departments, including Clinical Quality, Population Health, Dental, Pharmacy, Medical Management, and Health & Well-being.
- Utilization Trend Analysis: Conduct in-depth analysis of member utilization patterns, leveraging advanced analytics to identify key trends, anomalies, and opportunities for improvement. Translate findings into strategic recommendations to drive decision-making.
- Program Design and Implementation Support: Lead the ideation, design, and implementation of innovative intervention programs aimed at mitigating member spend while enhancing health outcomes. Collaborate with interdisciplinary teams to ensure seamless execution and alignment with organizational objectives.
- Strategic Planning and Advisory: Contribute to the formulation of long-term strategies by providing insights derived from data analysis. Offer advisory support to senior leadership, highlighting opportunities and risks within the clinical operations landscape.
- Data Drive Insights: Utilize innovative analytical tools and methodologies to interpret complex healthcare data in collaboration with the Data and Analytics team. Develop comprehensive reports to effectively communicate findings and recommendations to stakeholders.
- Collaborative Partnership: Work closely with cross-functional teams in Quality, Population Health, Health and Wellbeing, and Utilization Management to identify collaborative opportunities, streamline processes, and ensure cohesive implementation of initiatives.
- Continuous Improvement and Innovation: Stay abreast of emerging trends, regulations, and advancements in healthcare. Integrate new knowledge into strategies, fostering a culture of continuous improvement and innovation within the division.
- Bachelor’s in health administration or related field (Masters preferred)
- 5+ years of experience in healthcare program design and population health management.
- 5+ years of experience in healthcare settings, public sector, or health plan space
- 2+ years of experience in data analytics, statistical analysis, and business intelligence tools. (SQL, Excel, data visualization tools (Power BI)
- Strong understanding of healthcare operations, regulations, and trends.
- Excellent communication, presentation, and people skills.
- Ability to work collaboratively in a cross-functional team environment.
- Strong problem-solving and critical-thinking abilities.
- Analytical mindset with a strategic approach to problem-solving.
- Adaptability to work in a fast-paced, dynamic environment.
- Strong leadership qualities and the ability to influence and collaborate effectively.
- Meticulous with a focus on delivering high-quality results.
- Commitment to continuous learning and professional development in the healthcare
- Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
- A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
- Latency (ping) response time lower than 80 ms
- Hotspots, satellite and wireless internet service is NOT allowed for this role.
- A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
- Competitive pay/salary ranges
- Incentive plan
- Health/Vision/Dental benefits effective day one
- 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
- Robust employee well-being program
- Paid Time Off
- Personal Community Enrichment Time
- Company-provided Basic Life and AD&D
- Company-provided Short-Term & Long-Term Disability
- Tuition Assistance Program