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Manager, Population Health Programs

Prospect Medical Systems - Remote

Quick Apply

Job Details

Full-time $48 - $58 an hour 1 hour ago

Benefits

Health savings account
Health insurance
Dental insurance
401(k)
Flexible spending account
Tuition reimbursement
Paid time off
Work from home
Parental leave
Vision insurance
401(k) matching
Employee discount
Life insurance
Referral program

Qualifications

Microsoft Word
Microsoft Excel
Microsoft Outlook
Management
Managed care
RN License
Customer service
Bachelor of Science
HIPAA
Microsoft Office
Analysis skills
Bachelor's degree
Team management
Conflict management
Leadership
2 years
Communication skills

Full Job Description

To perform this job successfully, an individual must be able to perform the job description satisfactorily. This job description reflects management's assignment of essential functions, it does not prescribe or restrict the tasks that may be assigned. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Knowledge of HIPAA regulations preferred
Excellent written and verbal communication skills (50 WPM)
Exceptional customer service and conflict resolution skills
Must be able to work independently.
Ability to multi-task, prioritize, and work in a fast-paced environment
Must be proficient in Microsoft Office navigation, Excel, Outlook, Teams and Word and/or IDX knowledge.

Duties:

Manages Population Health Program areas including organizing and executing Population Health activities aimed to improve delivery of clinical services needs within Prospect Medical Systems, as well as government and regulatory requirements.
Continuously evaluates data outcomes, identifying alternatives, preventing unnecessary costs and services while ensuring quality care, and patient satisfaction.
Performs Supervisory audits as necessary to ensure compliance with all external and internal Population Health requirements and ensures the quality of care provided to members/beneficiaries.
Assists with the development and implementation of departmental policies and procedures.
Hires, trains, coaches, counsels, and evaluates their performance of direct reports.
Improves on the effectiveness and efficiency of PHP staff, through process improvements activities.
Provides leadership and supervision to supervisors, case managers, health educators, social workers, and care coordinators.
Oversees all Health Plan reporting completions and submissions in a timely manner.
Participates in interdepartmental and cross-functional meeting as needed. Serves as a liaison and resource between Population Health Program and other departments across the organization.
Other duties as assigned by Senior Director.

Qualifications for Internal Candidates

Required Education:

RN unrestricted active license required.
Knowledgeable in managed care, Medicare, Medicaid regulations, Model of Care and NCQA Population Health requirements.

Preferred Education:

Bachelor’s Degree of Science in Nursing and other related fields or higher preferred
2+ years of Population Health and/or Disease Management or other similar programs experience in managed care required.
Strong leadership skills with the ability to influence, manage, and motivate personnel.
Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.
Capable of resolving escalated issues arising from operations and requiring coordination with other departments.
Ability to prioritize and multi-task
Able to work independently and make independent clinical and non-clinical decisions
Excellent communication skills
Maintain professional attitude when working with internal and external customers
Adeptly utilize computer programs – both Microsoft Office applications and job-specific electronic software applications
Maintain and ensure confidentiality of patient information

Preferred Experience:

3+ years demonstrated leadership and team management/development skills preferred.
Experience in health plan audits and compliance is a plus.

Job Type: Full-time

Pay: $48.00 - $58.00 per hour

Expected hours: 40 per week

Benefits:

401(k)
401(k) matching
Dental insurance
Employee discount
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Parental leave
Referral program
Tuition reimbursement
Vision insurance
Work from home

Medical specialties:

Infectious Disease

Schedule:

8 hour shift
Day shift
Monday to Friday
No weekends

Experience:

Disease Management: 2 years (Required)
Population Health: 2 years (Required)

License/Certification:

RN License (Preferred)

Work Location: Remote

Quick Apply

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Manager, Population Health Programs

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