Sr. Director of Population Health
$31,200–$31,200 year
On-siteDalton, Georgia, United States
Job Summary
Develop and execute the organization's Population Health strategy to improve clinical outcomes, reduce avoidable utilization, and manage total cost of care. Lead the development of initiatives focused on preventive care, chronic disease management, care transitions, and health equity while establishing policies for medical and pharmacy management operations. Serve as a key clinical leader across provider, pharmacy, and executive teams to implement evidence-based programs that align with quality objectives and regulatory requirements. Monitor emerging healthcare trends and utilize analytics to drive continuous improvement in member engagement and care coordination. Partner with Pharmacy Benefit Management vendors and internal stakeholders to optimize pharmacy spend and promote medication adherence. Provide strategic oversight of utilization management, care management, and disease management programs while ensuring all clinical initiatives remain compliant with HEDIS, CMS, and NCQA standards.
Required Qualifications
- Master's degree in Nursing, Physician Assistant Studies, Healthcare Administration, Public Health, or related clinical field
- Current, unrestricted licensure as an Advanced Practice Provider (Nurse Practitioner or Physician Assistant)
- 7+ years - Clinical experience
- Experience in internal medicine, family medicine or emergency medicine
- Ability to interpret and explain complex government policies
- Knowledge of health plan operations and utilization management strategies
- Must be able to drive a vehicle
- Must be able to travel daytime/overnight as required
- Must maintain regular and predictable attendance
- Must consistently demonstrate compliance with HIPAA regulations
- Must consistently demonstrate compliance with professional conduct
- Must consistently demonstrate compliance with ethical practice
Desired Qualifications
- Current, unrestricted licensure as an Advanced Practice Provider (Nurse Practitioner or Physician Assistant) preferred
- Additional clinical certifications or advanced healthcare leadership credentials preferred
- 5+ years - Healthcare administration, including UM experience highly preferred
- Experience in specialty areas such as oncology, rehabilitation, and physical medicine preferred
- Board Certification in a recognized specialty by the American Board of Medical Specialties or the American Board of Osteopathic Specialists
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.