Commercial Population Health and Quality Manager

Presbyterian is seeking a Commercial Population Health and Quality Manager

PHP seeks a Senior Lead - Commercial Population Health and Quality to lead the implementation of cross-departmental programs and services to achieve optimal clinical and utilization outcomes for commercial members. The lead will represent the work of the population health and quality department to commercial clients and lead the development of proposal responses and reporting packages that demonstrate the value of PHPs offerings.

This is a Full Time position - Exempt: Yes
• Job is based at Rev Hugh Cooper Admin Center
• Work hours: Weekday Schedule Monday-Friday

Ideal Candidate:

• Masters degree.
• 3 years of relevant leadership experience required
• 3 years of Managed Care Organization (MCO) experience required

• Masters degree in healthcare leadership, business, public health, or other relevant field required
• 3 years of relevant leadership experience required
• 3 years of Managed Care Organization (MCO) experience required
• Ability to derive population health insights from aggregated data
• Ability to develop KPIs and use quality metrics to drive a continuous quality improvement cycle
• Knowledge of value-based programs and contracting
• Excellent analytical and organizational skills with strong attention to detail
• Ability to present qualitative and quantitative data to a variety of high-level audiences
• Ability to meet tight deadlines
• Project Management skills preferred

• Leads the design, implementation, tracking, and evaluation of the population health and quality approach for commercial members
• Designs solutions that meet the specific needs of commercial accounts
• Oversees the implementation of analytics and reporting approaches to convey the value of PHPs population health and quality programming to commercial clients
• Serves as the lead population health and quality contact for commercial clients, regularly meeting with clients in the field to understand priorities, build relationships, and convey PHPs value
• Serves as the author of proposal responses and related to commercial population health and quality
• Maintains knowledge of up-to-date best-practice approaches to achieving best in class clinical and utilization outcomes for the commercially insured population
• Works in partnership with key leaders to develop and implement payment and reimbursement strategies in alignment with the organization's vision, goals, and strategy
• Deploys cross-departmental strategies to ensure commercial members are aware of and engaged in programming to promote self-management of chronic conditions and completion of evidence-based preventative care and treatment
• Ensures broader Presbyterian offerings, including wellness and community programming, are integrated into PHPs population health and quality approaches for commercial members
• Serves as the business lead for procurement, implementation, and evaluation of vendors and partnerships offering clinical services to the commercial population

About Presbyterian Healthcare Services
Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits.

The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities - like challenges, webinars, and screenings - with opportunities to earn gift to earn gift cards and other incentives.

As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships. Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.