0 suggestions are available, use up and down arrow to navigate them
What job do you want?

Create Job Alert.

Get similar jobs sent to your email

Apply to this job.
Think you're the perfect candidate?
Manager Population Health - Hybrid of Choice at Blue Cross and Blue Shield Association

Manager Population Health - Hybrid of Choice

Blue Cross and Blue Shield Association Philadelphia, PA (Onsite) Full-Time
Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.

Servicing a defined segment of multiple provider types (e.g. pediatric practices, family/internal medicine practices, specialist practices, etc.) with various levels of complexity in New Jersey, the Manager, Population Health role is designed to manage and optimize the day-to-day efforts and overall impact of the Population Health Specialists. This role manages the Population Health Specialist team and assists in the ongoing development and implementation of continuous quality improvement strategy related to critical performance measurement systems (CMS Stars & HEDIS) and more. The role will work with providers that include primarily PCP's and integrated delivery systems but may extend to specialists and hospitals.

Responsibilities include, but are not limited to:

* Manages the day-to-day activity of the population health team to ensure required goals related to provider interactions along with ensuring CMS Stars performance is optimized
* Manages the population health relationships with Integrated Delivery Systems
* Manages the continued build-out of the Microsoft Dynamics 365 Customer Relationship Management tool and ongoing enhancements to support the Population Health Specialists
* Supports internal teams that have a constant focus on upcoming CMS STARS measure changes and resulting need for program enhancements
* Participates in the development and implementation of programs to improve CMS STARS ratings. Analyzes effectiveness of programs developed to improve CMS STARS results.
* Supports the improvement of provider experience; communicates provider concerns and clinical issues to AmeriHealth & IBX's key stakeholders.
* Other duties as assigned.

Qualifications and Education

* Bachelor's degree required
* Master's degree in health-related field preferred (MPH, MHA, etc.)
* 3+ years management experience, preferably in a health-care related organization

Experience, Knowledge, & Skills

* Experience implementing population health and/or value-based program strategies to achieve successful quality outcomes
* Strong ability to cultivate & develop positive external relationships
* Experience managing teams and using goal specific results to evaluate performance
* Demonstrated strong verbal and written communication skills including but not limited to effective group presentations to professional staff and management
* Must be self-motivated, organized, and detail oriented
* Must be able to work moderate complexity tasks independently
* Knowledge of medical billing, claims processing systems, electronic health records, and health care information terminology preferred
* Prior relevant health plan experience and/or in provider offices and facilities is a strong plus.
* Must have strong usage Microsoft Office products (Outlook, Word, Excel, PowerPoint) and SharePoint.
* Must have strong analytical, influencing, and problem-solving skills
* Demonstrate strong ability to communicate with all levels of staff and management confidently and effectively
* Ability to travel in the state of New Jersey is required (driver's license and insured vehicle)

Hybrid of Choice:

Independence has implemented a "Hybrid of Choice" model which provides our associates with the flexibility to choose whether to work remotely, work in the office every day, or work in the office on certain days at their discretion. However, management may require our associates to work from Independence's physical office locations on certain occasions. This role is designated as a role that fits into the "Hybrid of Choice" model. While associates may work remotely, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.

Independence Blue Cross is committed to the health, safety, and well-being of our associates. In support of that focus, Independence expects all new hires to be up to date with COVID-19 vaccination and booster*. Independence's policy provides reasonable accommodations for medical or religious reasons as required by law. The process for requesting a reasonable accommodation is communicated to candidates when they are offered employment.

* To be considered "up to date" with COVID-19 vaccination and booster, individuals must have received an initial series of the vaccine (whether a 1-dose or 2-dose series) and timely receive a booster once eligible. Individuals not yet eligible to receive a booster shot will be required to timely obtain a booster once eligible.

Recommended Skills

  • Analytical
  • Attention To Detail
  • Claim Processing
  • Clinical Works
  • Coaching And Mentoring
  • Communication
Apply to this job.
Think you're the perfect candidate?

Help us improve CareerBuilder by providing feedback about this job:

Job ID: 2470907811

CareerBuilder TIP

For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more.

By applying to a job using CareerBuilder you are agreeing to comply with and be subject to the CareerBuilder Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.