Director Population Health Quality and Care Coordination

Leads the quality and care coordination functions for St. Joseph’s Population Health programs through the oversight of: (1) the implementation and ongoing management of the quality and performance metrics under  St. Joseph’s clinically integrated network; (2) contracted health plan quality programs that meet CMS (Center for Medicare & Medicaid Services) and NCQA (National Committee for Quality Assurance) requirements; (3) quality initiatives for performance-based payment programs, such as the HEDIS (Healthcare Effectiveness Data and Information Set) portion of Medicare Advantage Stars Ratings for contracted MA (Medicare Advantage) plans, CMS ACO (Accountable Care Organizations), QIP-NJ program, CMS Transforming Episode Accountability Model (TEAM), and  similar programs; (4) coordination of care gap closure efforts with other physician-facing initiatives. Drives the customization, launch, and ongoing operations of  St. Joseph’s population health management programs, including gaps in care programs for patient populations under contract with St. Joseph’s.

Qualifications
Work requires the knowledge of theories, principles, and concepts normally acquired through completion of a Bachelor's degree in Nursing, other clinical specialty, or Business/Public Administration, Master's preferred, and five to seven years of previous work related clinical and/or health care management experience with a general understanding of performance measures (e.g. NCQA/HEDIS measures, MSSP (Medicare Shared Savings Program). Previous managed care and/or clinical environment preferred, including minimum of two years Medicare and/or dual eligible quality management experience in a managed care setting. Knowledge and/or experience with process improvement methodologies such as lean six sigma preferred. Work requires analytical ability to collect information from diverse sources and apply professional principles in performing various analyses, and summarize the information and data in order to solve problems

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.