Fellowship - Designing Countywide Framework to Optimize Public Health Investments

Fresno County is working to strengthen the efficiency and equity of its public health services by aligning investments with measurable outcomes. The FUSE Executive Fellow will design and pilot a countywide return-on-investment (ROI) framework that connects spending to impact, improves data-driven decision-making, and guides equitable resource allocation. Ultimately, this project will enhance accountability, expand access to quality care, and improve long-term health outcomes for communities across Fresno County.

Fellowship Dates:
April 27, 2026 – April 23, 2027

Salary:Executive Fellows are FUSE employees and receive an annual base salary of $95,000. Fellows can also access various health, dental, and vision insurance benefits. Compensation for this year of public service is not intended to represent market-rate compensation for the experienced professionals in our program.

FUSE is a national nonprofit dedicated to increasing the capacity of local governments to work more effectively for communities. We embed private sector executives in city and county agencies to lead projects that improve public services and accelerate systems change. Since 2012, FUSE has led over 400 projects in 58 governments across 26 states, impacting a total population equivalent to 1 in 10 Americans.

When designing each fellowship project, FUSE works closely with government partners and community stakeholders to define a scope of work that will achieve substantive progress toward high-priority local needs. Projects address today’s most pressing challenges and opportunities, including affordable housing, economic mobility, climate resilience, public safety, infrastructure, technology, and more.

FUSE conducts a full executive search for each individual project to ensure that the selected candidate has at least 15 years of professional experience, the required competencies for the role, and deep connections to the community being served.

Executive Fellows are embedded in government agencies working with senior leaders for at least one year of full-time work. Prospective responsibilities may include thorough data analytics and research, developing enhanced operations and financial models, building change management and strategic planning processes, and/or building broad coalitions to support project implementation efforts. Executive Fellows are data-driven and results-oriented and able to effectively manage complex projects.

They build strong relationships with a broad array of stakeholders, foster alignment within and across various layers of government, and build partnerships between governments and communities.

Throughout the fellowships, Executive Fellows receive training, coaching, and professional support to help achieve their project goals.

Improving the effectiveness and equity of public health services such as maternal and child health programs is essential to advancing community well-being and ensuring that all residents benefit from quality care. In Fresno County, CA, while individual families who receive county services frequently experience positive outcomes, these results often fail to translate into broader, population-level improvements. For instance, African American residents continue to experience the highest rates of infant mortality and preterm births, and Latino and Southeast Asian families, who represent a growing share of births, continue to have limited access to culturally responsive services.

At the same time, ongoing reductions in federal and state public health funding have forced the Department of Public Health (DPH) to make difficult decisions about how to allocate limited resources. A clear understanding of which investments deliver the strongest returns is vital for Fresno to reduce health burden and improve health outcomes for its most vulnerable populations.

To address this challenge, Fresno County DPH has strengthened its data collection systems, refined charting processes, and built capacity to link financial data with health outcomes. The department maintains strong fiscal tracking tools and is working to improve its ability to analyze the…