Director - Population Health and Quality

Under the direction of the Executive Director of Population Health and Quality Operations, identifies and deploys clinical innovations and member and provider level interventions to improve overall population health and wellbeing, meet clinical quality goals, and reduce unnecessary or avoidable utilization. This leader works with integrated system providers, community-based organizations, network providers, and care coordination staff to achieve organizational performance goals.

You will drive operational area prioritization, alignment, and accountability for the quality improvement and population health goals. Key liaison to stakeholder quality and population health leaders, including NM Medicaid.

• Bachelors degree required, Masters degree preferred
• 3 years management experience required
• 5 years experience in clinical quality or population health required
• Experience with HEDIS and MA Stars data and processes required
• Experience deploying continuous quality improvement techniques required
• Experience in program development and evaluation required
• MCO experience strongly preferred
• Familiarity with Medicaid, Medicare, and Dual Eligible populations strongly preferred
• Experience using data to derive insights that guide program and intervention development, knowledge of key healthcare data sources and concepts, including claims, risk stratification, and quality measurement strongly preferred
• Demonstrated ability to influence key leaders in a complex organization

• Oversee the performance improvement program management team responsible for deploying interventions aimed at meeting performance measures.
• Lead work teams through definition, design, and creation of specific program project plans, and creates and manages timelines, budgets, completes project status reports, facilitates team meetings, and maintains progress through completion.
• Coordinate with operational leads across PHP and PHS to align priorities, implement innovations and evaluate outcomes.
• In collaboration with the Director of Health and Social Equity, works to incorporate an equity lens into all improvement strategies, including quality, patient safety and population health, to advance health and wellbeing and the member experience.
• Support the population health cycle, including the identification and stratification of subpopulations, deployment of whole person clinical interventions across the continuum of care, continuous population surveillance, and use of the continuous quality improvement cycle to drive program effectiveness and achieve outcomes.
• Work closely with PHP's VBP Center of Excellence to support providers in meeting high priority clinical quality measures and inform the decision of VBP arrangements to support quality goals.
• Promote a continuous quality improvement culture within the organization and work across departments to ensure key departments identify opportunities and deploy plans to support quality goals.
• Work with the analytics team to define overall evaluation strategies, including defining key performance indicators and methods for continuous quality improvement.
• Ensure delivery of high-quality regulatory documents related to population health and quality, including performance measure reporting to HCA.
• Work to integrate the population health and quality framework into operational areas, including clinical and service departments.
  
  

We offer more than the standard benefits!

Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more!

Learn more about our employee benefits:

https://www.phs.org/careers/why-work-with-us/benefits

Why work at Presbyterian?

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.

Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.

About Presbyterian Healthcare Services

Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

About New Mexico

New Mexico continues to grow steadily in population and features a low cost-of living.

Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.

New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.