|Employer:||Duke University Heath
|Skills:||HEDIS,Star measures,Risk Coding,Risk Adjustments,Value Based Payment Models knowledge and experience
|Preferred Certifications:||Certified Risk Adjustment Coder (CRC) and Certified Professional Coder (CPC) certifications preferred
|Required Experience:||5 to 7 years
|Location:||705 Fuller Street Durham 27708, NC, US* Note: This listing is for a remote position
The Director of Population Health provides overall administrative direction and leadership for clinical staff, non-clinical staff, policies, procedures and programs. The Director will participate in the analysis, planning and strategic formation of PHMO's services. Serves as a member of the PHMO Leadership Team. This position will have two direct reports (Population Heath Specialist and Population Health Nurse) Remote optionable (onsite as needed). Hours: Monday-Friday, 8am-5pm. Some local travel maybe required
- Direct personnel actions related to areas of responsibility including, but not limited to hiring, performance management, staff development, disciplinary action, etc.
- Oversee developmental opportunities for PHMO staff. Develop and implement continuing education programs and services to meet identified needs.
- Provides executive leadership and clinical oversight for the development and implementation of strategic and operational plan for clinical services, and programs within population health management. Communicate plans and continuously evaluate plans Participates in certification, accreditation, and audit procedures, keeping abreast of local and state laws affecting clinical professional practice and industry regulations. Ensures that reports required by regulatory agencies are prepared and submitted within established timeframes.
- Establishes and implements processes to assure the integration/coordination with the provider network in delivering on quality and utilization key performance indicators and leading the effective implementation of value-based contracts. Identify and implement new programs that continuously improve patient outcomes in conjunction with other PHMO leadership and across the health system.
- Ensure coordination and integration with other Duke departments and/or outside groups as needed to ensure high quality, efficient clinical patient care. May ensure efficient and orderly performance of customer contact and enterprise-wide marketing activities.
- Maintain liaison with all levels of administration, physicians and outside organizations to accomplish directives and to facilitate the resolution of problems.
- Represent the Population Health Management Office in meetings, conferences and maintenance activities regarding clinical patient care operations.
Knowledge, Skills and Abilities
- Leadership and management in healthcare organizations required.
- HEDIS, Star measures, Risk Coding, Risk Adjustments experience required
- 3-5 yrs. of Value Based Payment Models knowledge and experience required
- Strong organizational abilities and experience in project management
- Knowledge of Commercial, Medicare and Medicaid regulations and standards, particularly with quality (HEDIS/Star measures) and risk coding programs
- Demonstrates extensive knowledge, understanding and ability to work with multi-health systems and organization missions
- Excellent interpersonal, verbal, written, organizational, analytical and presentation skills.
- Facilitation, consensus-building, and negotiation skills.
- Sensitivity for and understanding of clinical disciplines and issues.
- Understand cost containment and managed care systems.
- Computer skills including Microsoft Office suite of products, as well as utilizing healthcare software for patient management and documentation.
- Ability to work with all types of individuals in multiple settings and locations and to promote diversity in the workplace
Work requires completion of an accredited bachelor's degree in a healthcare field such as nursing, occupational therapy, social work, psychology, or counseling with a professional licensure or registration in a clinical field and a Master's degree. Certified Risk Adjustment Coder (CRC) and Certified Professional Coder (CPC) certifications preferred
Work requires minimum of six years of progressive managerial experience, generally in a hospital, health care, or health plan managing clinical staff and programs involving quality of care, patient/provider satisfaction, staff satisfaction, and financial performance. A Master's degree in Hospital Administration, Business Administration or another human service related field is preferred.
Degrees, Licensures, Certifications
See Education. Certification in Care Management or Care Management Administration within 6 months of hire.