Director, Population Health - Rochester or Schenectady
MVP Health Care 32 reviews - Rochester, NY

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The Director of Population Health will provide oversight, leadership and direction for the implementation of focused case and disease management interventions targeted to improve members and providers satisfaction, decrease costs, maximize quality and improve clinical outcomes. Works in close collaboration with other management teams across MVP to assure integration of key functions and processes. Develops an annual case management and disease management program description and workplan outlining key areas for improvement. Executes workplans, monitors results, develops and documents progress reports. Establishes and defines targets for case management and disease management cost-savings and tracks cost-savings. Plan, develop, implement and evaluate processes and guidelines for managing care across the health care continuum for MVP Health Care members enrolled in case management and disease management programs. Ongoing monitoring, evaluation, and revision of diagnostic and utilization triggers and stratification criteria used to identify appropriate members for case management intervention. Oversees the development and implementation of case and disease management tools that incorporate peer reviewed clinical guidelines and represent best practices . Participates in the development and provides leadership in the implementation of new case and disease management strategies and initiatives. Evaluates current case and disease management programs against stated targets and goals to identify improvement and program redesign opportunities. Ensures that external regulatory and review agency requirements involving case and disease management are met. Develop and monitor department s annual budget. Establishes clear directions, sets challenging, but achievable performance objectives, prepares performance reviews and action plans for direct reports. Responsible for orientation, ongoing coaching and mentoring of Case and Disease Management Supervisors. Promote a spirit of cooperation, collaboration and integration with other Medical Management Departments across MVP and other departments in the organization. Coordinates with Health Services Operations, Quality Management and Utilization Management regarding formal outcome plans and measurement where appropriate. Identifies opportunities for appropriate cost containment and collaborates with multidisciplinary team for implementation. Complete other duties regarding Population Health Management as assigned by Vice President of Health Services. Minimum Education: Registered Nurse with current New York State license. Bachelors degree in health related field. Master s degree preferred. Minimum Experience: Eight (8) years varied health-related experience. Management experience required. Program development experience required. Managed care experience/understanding required. Case Management experience/certification preferred.
Required Skills: Working knowledge of Government Program care management delivery system required. Demonstrated understanding/application of research methodology, statistical analysis, and medical terminology. Ability to organize and present data effectively. Ability to use discretion in handling confidential information. Excellent oral and written communication skills. Ability to work independently and prioritize multiple assignments to meet deadlines.Some travel required within MVP s service area


About this company
32 reviews
MVP Health Plan covers about 650,000 most valuable people. Also known as MVP Health Care, the company provides health insurance and employee...