Director Clinical Programs Excellence

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Responsibilities

Under the general direction of the VP Population Health Program Excellence, the Corporate Director of Population Health Clinical Program Excellence is responsible for the interdisciplinary development of clinical programs for Population Health across all corporate lines of business. The Corporate Director of Population Health Clinical Program Excellence will facilitate a prioritization process which takes into account population needs analyses, contract requirements, growth and RFP needs, leadership input, and more to identify clinical program opportunities for evaluation. Once programs are approved for development, the Director will guide a team of Population Health Advisors in the design, co-development with operations, implementation, and portfolio level measurement of each program.

A successful leader will perform well in a fast-paced environment, will have an evidence-based mindset with attention to operational needs and measurement detail, and will focus on identifying value to challenging business problems. This position requires strong business acumen, cross functional and collaborative expertise and savvy, exceptional communication skills, and the ability to make complex concepts simple and easy to understand.

This includes the following

Firm understanding of government programs including Medicaid, Medicare DSNP, LTSS, ExchangeActive role in the dissemination of best practices throughout the AmeriHealth Family of Companies and assists with change management and new business opportunities and implementation. Provide clinical thought leadership in population health program design, development, and measurement. In conjunction with VP Population Health Program Excellence, provide key leadership in promoting and integrating evidence-based approaches into the care management systems and intersection points to manage members, providers, and total cost of care. Identify key performance metrics for each program and work with enterprise analytics to ensure process and outcomes measurement. Codify design through program descriptions and ongoing reporting and analytics to ensure operational processes are meeting contractual timelines and SLAs. Oversee effective use of policies, and cross functional solutions to ensure consistent, effective and efficient delivery to members while meeting regulations and internal business and clinical objectivesReview periodic reports (financial/utilization/services) to analyze trends, identify opportunities and ensure consistent deployment of , accurate data according to established polices & procedures across enterprise and market teamIdentifies areas where staffing efficiency and effectiveness could improve program outcomes within the markets or programs Monitors performance metrics across LOBs and makes recommendations to leadership so that appropriate action is taken to address performance opportunities consistent with enterprise policiesMeasures local market program proof points to identify any program opportunities for scaleIdentify long-range, competitive strategies for Medicare Solutions /Population Health programPartner with medical directors, enterprise, and market leaders in the development of best practices and shared learnings

Education/ Experience

Bachelor’s Degree in Healthcare related fieldRN Preferred5 to 10 years clinical experience, leading teams

Diversity, Equity, and Inclusion

At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.