POSITION SUMMARY/RESPONSIBILITIES
Promotes a population health management approach to health care within a managed health care environment for assigned product lines including STAR Kids, STAR+PLUS, Medicare Advantage and Medicare Advantage Dual Special Needs Plan (D-SNP). Supports Community First's goals to prevent illness, injury, disability and early mortality across the entire continuum of care with a particular focus on those portions of the population at greater risk of poor health. Leads the development of an evidence-based population health strategic plan, emphasizing primary, secondary, and tertiary prevention. Utilizes available data and technology to risk-stratify Community First members into an appropriate level of care management. Actively participates with the directors, managers and team leaders across the organization is essential to facilitate integrated service delivery, planning, quality assurance, risk management and to address the needs of members and their families to protect and promote member healthcare. This position reports to the Chief Medical Officer.
EDUCATION/EXPERIENCE
Bachelor's degree in Nursing is required. Master's degree is preferred. Minimum of ten years of clinical experience is preferred. In addition, five years of experience in a managed care organization preferred. Experience in Texas Medicaid programs, specifically STAR Kids and STAR+PLUS is highly preferred. Minimum of four years in an executive leadership experience. Previous formal training and/or experience in strategic planning is preferred. Demonstrated policy and planning formulation and implementation skills. Proven ability to build, manage and foster a team-oriented environment. Advanced conceptual and analytical skills including the ability to use and interpret statistical data and produce high quality reports. Exemplary written and oral communication skills.
LICENSURE/CERTIFICATION
If a Registered Nurse, must be licensed in the State of Texas.