Director of Population Outcomes - CA & WA

Director of Population Outcomes leads utilization-management and cost-improvement initiatives for the CA & WA market population within ConcertoCare’s population health program. Responsibilities include identifying and analyzing impactable utilization trends with interdisciplinary teams; performing root cause analysis on inpatient admissions to develop and implement strategies to avoid future preventable utilization; preparing case summaries to guide interdisciplinary planning; performing population surveillance to identify rising risk patients and plan care; using internal/external reporting tools to guide opportunities to reduce avoidable utilization; designing and managing projects with Market Medical Director(s) and Population Outcomes Manager; partnering with actuarial/med econ teams to identify cost and utilization trends and potential improvements; compiling data for Joint Operating Committee meetings; supporting external meetings with payer case management, provider partners, and community resources; leading market-level SWAT huddles and presenting on medical-expense management; collaborating with leadership to execute utilization-management initiatives and set annual goals; requires Master’s degree and Board Certified Nurse Practitioner licenses in CA/WA or ability to obtain; 5+ years clinical experience including 3+ years in value-based care; strong data analysis and reporting skills; proficient with Microsoft Office and SharePoint.