Population Health Specialist, Senior

The Population Health Specialist, Senior is an advanced role focused on developing and implementing initiatives that improve health outcomes for Medicaid and Medicare members. The position provides guidance, leads high-impact projects, and collaborates with internal and external partners to drive data-driven decision-making and program development. This role is highly collaborative and requires a high degree of initiative and systems thinking to lead and work in tandem with internal teams and external partners to support and improve population health outcomes across the health care system and community.

$81,000.00 - $99,000.00

Bonus - SIP Target, 5% Annual

• Develop and oversee high-impact population health initiatives that align with organizational and Medicaid/Medicare objectives.
• Lead the development and execution of innovative member engagement programs to improve care coordination and access to preventive care.
• Lead and manage complex population health initiatives from inception to completion, ensuring strategic alignment with organizational goals; initiatives may span across multiple geographies.
• Develop and oversee project timelines, key milestones and success metrics to measure impact.
• Proactively identify potential risks and barriers; develop mitigation strategies to keep projects on track.
• Collaborate with cross-functional teams and leadership to drive project execution and ensure seamless implementation.
• Monitor program performance, propose and implement adjustments based on healthcare performance metrics and data insights.
• Monitor and assess the impact of population health initiatives through metrics, reporting and continuous improvement.
• Lead development and implementation of strategies to address cost, utilization and quality of care; support reduction of health disparities among vulnerable populations.
• Maintain project documentation and deliver regular status updates to leadership and invested parties.

• Establish and strengthen partnerships with healthcare providers, community organizations and other stakeholders to drive collaboration.
• Lead in the communication and translation of population health strategies, priorities, best practices and updates.
• Lead the discussion on workflow optimization including process evaluation, identification of bottlenecks and inefficiencies and areas of improvement.
• Resolve barriers to meeting key population health priorities through high-level leadership meetings with the line of business and departments.
• Research population health approaches and market practices and provide recommendations in partnership with content experts and multiple stakeholders; work to integrate programs and strategies across multiple LOBs.
• Design and lead collaborative meetings with internal and external partners to identify opportunities and implement interventions that improve quality, utilization and health outcomes.
• Represent the organization in statewide learning collaboratives related to population health projects.
• Provide guidance and direction to mid-level positions.

• Lead training and orientation efforts for internal teams and partners on advanced population health strategies, best practices and self-service data utilization as needed.
• Provide technical assistance to support operationalization of complex projects that may include education and training, addressing staffing models, workflows, documentation support, data collection, monitoring/evaluation approaches and referral relationships.
• Serve as a senior subject matter expert in population health, offering thoughtful guidance and data-driven recommendations for program and systems improvement.
• Translate complex data insights and provide actionable strategy recommendations to guide decision-making and support organization-wide department implementations.
• Provide data-informed recommendations for targeted interventions to improve cost efficiency and optimize care delivery.
• Mentor junior staff and contribute to capacity-building, consultative and prioritization efforts across the population health team.

• Lead the review and interpretation of existing dashboards and reports to analyze healthcare utilization trends, cost drivers and quality care gaps.
• Interpret and report on healthcare quality metrics such as HEDIS, NCQA, CMS Star Ratings and CCO performance measures.
• Develop reports and presentations and communicate findings and strategic recommendations to leadership and key invested parties.
• Collaborate with data teams to refine reporting tools and ensure data accuracy and relevance for population health initiatives.
• Ensure organizational compliance with Medicaid, Medicare and state-specific healthcare regulations and reporting requirements.

• Minimum 6 years’ experience in population health, public health, health care management, quality improvement or a related field
• Minimum 1 year of…