Quality Improvement And Population Health Director

We have an opportunity to join the Alliance as the Quality Improvement and Population Health Director, leading the Quality Improvement and Population Health Department. 

PURPOSEFUL WORK

Central California Alliance for Health is a Medi-Cal Health Plan with $1.5B in revenue and serving 400,000+ members.  We partner with our contracted providers to promote prevention, early detection and effective treatment, and improve access to quality health care for those we serve. This results in the delivery of innovative community-based health care services, better medical outcomes and cost savings.

We are 500-ish employees who are all working towards our vision of Healthy People, Healthy Communities by living out our values of Equity, Integrity, Improvement and Collaboration in the pursuit of our mission of accessible, quality health care guided by local innovation. Learn more about our history, members, and partnerships here.

Reporting to the Chief Medical Officer, you will:

• Provide strategic management oversight in implementing, directing and monitoring the Alliance's Quality Improvement and Population Health Department functions
• Direct the Quality Improvement and Population Health Department, act as a subject matter expert, and provide executive level advice and guidance on the Department's functions and overall business operations
• Direct, manage and supervise Quality Improvement and Population Health Department staff

ABOUT THE TEAM

We look at where there are gaps and pain points in current systems and develop processes to solve them, as well as consider future processes that will increase efficiency and effectiveness.

THE IDEAL CANDIDATE 

• Be a motivated and seasoned leader within the managed care industry
• Have exceptional communication skills, with strength in relationship building, influencing others, and leading cross-functional teams
• Have knowledge of health plan regulations and collaborating with regulatory bodies
• Have excellent analytical skills and the ability to synthesize information into high-level executive presentations 
• Be invested in staff development and empowering teams to do their best work
• Champion accountability across the organization
• A must: Managed care/health plan experience
• A plus: Medicare experience

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here. 

• Knowledge of:
• The principles and practices of quality improvement and population health
• The healthcare industry and the principles and practices of healthcare planning, population management, and process and outcomes measurement
• Principles and practices of a value-based healthcare environment
• The principles and practices of managed care 
• Medi-Cal, Title 22, Knox Keene, Medicaid, Medicare, entitlement programs, and related regulations
• State and Federal legislative processes
• Ability to:
  • Direct, manage, supervise, mentor, train and evaluate the work of staff 
  • Develop, plan, organize and direct programs and activities that are complex in nature and regional in scope
  • Provide leadership, facilitate meetings, and partner with and guide managers and employees in the resolution of issues 
  • Demonstrate strong clinical skills and  evaluate medical records and other health care data
  • Review and assess overall department function, core work, goals and structure, develop and implement short- and long-term planning to achieve strategic plans, and complete an annual department assessment
• Education and Experience:
  • Current unrestricted license as a Registered Nurse, Physical Therapist, Occupational Therapist, Podiatrist, Respiratory Therapist, or other health care license issued by the State of California
  • Bachelor's degree in Nursing, Health Administration, Behavioral Health, Social Science or a related field
  • A minimum of ten years of quality improvement experience which included a minimum of five years of experience in a managed care environment, four years of clinical experience, and three years of staff management experience(a Master's degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

OTHER DETAILS

• While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely
• Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected
• Based on the nature of work, this position may require office presence or travel within our service counties, which is dependent on business need. Details about this can be reviewed during the interview process.

COVID-19 Vaccine Requirement: This position requires staff to be fully vaccinated and boosted upon their start date as a condition of employment. Proof of vaccination must be submitted at time of hire. Fully vaccinated is defined as receipt of the second dose in a 2-dose series (ex: Pfizer & Moderna vaccines) OR receipt of a single-dose vaccine (ex: Johnson & Johnson); AND receipt of the booster (if eligible); AND a 2-week period having passed since the administration of the last vaccine dose.