Manager Population Health

Capital Health is the region’s leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than
600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization.

As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.

The listed pay range or pay rate reflects compensation for a
full-time equivalent (1.0 FTE)position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).

$92,289.60 - $

40

• Bachelor’s Degree in Nursing, Social Work, Public Health, or other healthcare-related field

• Valid New Jersey and Pennsylvania Registered Nurse (RN) or Social Worker (LSW/LCSW) license or in the process of obtaining PA licensure
• AHA BLS - Healthcare Provider

• Four years of clinical experience in acute care, ambulatory/outpatient, sub-acute rehabilitation, care management, managed care health plan or related setting

• Demonstrated knowledge of ACO models, MIPS compliance, HEDIS measures and structured care coordination workflows
• Core understanding of workflow design, with a demonstrated ability to translate program goals into operational workflows
• Working knowledge of value-based care models, quality measures, care management and transitions of care
• Practical data analysis skills, including the ability to interpret and extract health reports
• Strong computer skills, including the ability to navigate multiple electronic medical documentation systems
• Excellent verbal and written communication skills, including the ability to convey complex information clearly to a diverse group of stakeholders

• Proven ability to direct daily work autonomously while remaining collaborative with peers and leadership
• Demonstrated ability to pivot quickly, manage multiple workflows simultaneously and remain effective in a fast-paced, high-volume environment
• Natural ability to build collaborative relationships across diverse teams while influencing, guiding and motivating staff

• Master’s degree in Nursing, Social Work, Public Health or other healthcare-related field

• Case Management, Ambulatory Care, Care Coordination or other relevant professional certification

• Two years of supervisory, team lead or program management experience
• Direct experience in a Population Health setting

• Provide day-to-day oversight for the Ambulatory Population Health team, including active workload distribution and staff productivity monitoring
• Collaborate on the design, implementation and evaluation of ambulatory quality programs across all Capital Health Medical Group practices
• Standardize population health workflows, including risk stratification, care management, transitions of care and quality measure gap closures
• Audit clinical data and health reports from electronic medical records (EMR) and payer systems to prioritize patients for care management enrollment
• Monitor team performance metrics against external program requirements, HEDIS measures and internal organization targets
• Coordinate patient care delivery across primary care, specialty practices and outside community resources to address social determinants of health (SDOH)
• Partner with population health vendors to streamline care management systems, ensuring thorough, consistent documentation for accurate compliance reporting
• Lead the talent lifecycle for the team, including interviewing, selection, onboarding, training, performance evaluations and ongoing professional development
• Develop operational reference tools, training materials and structured process improvement initiatives to elevate team performance
• Contribute to departmental budget management, program planning and strategic resource allocation
• Perform other duties as assigned