Supervisor, Population Health Management (Quality Initiatives)
Posted on: June 10, 2021
Department(s): Population Health Management (PHM)
Reports to: Manager, Population Health Management
FLSA status: Non-Exempt
Salary Grade: M - $85,000 - $121,000
The Supervisor of Population Health Management will be
responsible for daily operation of Population Health Management
activities and supervision of Population Health Management staff.
The Supervisor will work under the direction of the Manager and in
partnership with the Director and/or other department leadership to
support department goals and program implementation. The Supervisor
will provide guidance to staff, directly handle complex Population
Health Management referrals and requests for Population Health
Management services, monitor staff goals and productivity, ensure
compliance with cultural and linguistic requirements and processes,
and compliance with desktop procedures, organizational policies, or
contractual requirements. Serve as a resource for CalOptima
providers, health networks and community partners. Flexible
schedule requires availability to participate in evening and
- Oversees the process, management, implementation, and
evaluation of quality initiatives such as improvement projects,
member and provider incentive programs, provider education
activities, targeted member outreaches, etc.
- Contributes significant narrative for regulatory deliverables
including PDSA, PIPs, QIPs, CCIPs and other quality improvement
projects for various regulatory and accreditation agencies (DHCS,
CMS and NCQA).
- Analyzes health care data and be able to assess statistical
validity of rate changes to inform evaluations and future planning
or strategy adjustments.
- Demonstrates leadership and oversight ability by providing
staff guidance, training, and support for the implementation of
improvement projects, special projects, and pilot programs which
may include activities such as holding focus groups, conducting
research or surveys.
- Assists with QI work plan strategic planning, implementation
and write up of annual evaluation using evidence-based findings
showing how efforts have closed gaps in care in HEDIS, MCAS and
other organizational goals.
- Facilitates meetings with PHM staff, other department staff or
other community organization collaborators in planning execution of
- Ensures adherence to regulatory requirements for quality
improvement projects such as completing and submitting quality
improvement projects, performance improvement projects, rapid cycle
improvement projects, and improvement plans.
- Collaborates with various departments to obtain data, send
communications, and implement quality improvement activities.
- Partners with the Population Health Management leadership to
develop and member and provider interventions in support of
- Supports the Manager of Population Health Management with the
development, tracking and updating of Population Health Management
and member informing materials to ensure compliance with regulatory
- Participates in the hiring process and training of new
Population Health Management staff.
- Provides guidance and support for the implementation of special
projects and pilots, or directly handle complex Population Health
Management requests from members, providers, or staff.
- Assists with the development and oversight of Population Health
Management programs, work plans, budgets, and reports.
- Assesses activities and other process improvement strategies to
enhance the effectiveness of Population Health Management
- Aids with developing, documenting, implementing, and updating
- Acts as a resource for CalOptima providers, health networks and
- Participate in internal and external committees, coalitions,
and events such as health fairs as appropriate.
Maintains knowledge of the latest advances and research on
various health topics.
- Other projects and duties as assigned.
Possesses the Ability To:
- Establish and maintain effective interpersonal relationships
with staff at all levels, providers, other program or agency
representatives, and the general public.
- Systematically evaluate work and apply skills to continuously
- Provide excellent customer service.
- Initiate and follow through on projects with minimal
- Work well as part of a team to manage/lead multiple projects
- Think critically to solve problems effectively.
- Communicate clearly and concisely, both verbally and in writing
with individuals from varying cultural and ethnic backgrounds.
- Utilize computer and appropriate software (e.g., Microsoft
Office: Word, Outlook, Excel, PowerPoint) and job specific
applications/systems to produce correspondence, charts,
spreadsheets, and/or other information applicable to the position
Experience & Education:
- Bachelor's degree in Public Health or related field
- 5+ years Population Health Management experience required.
- 2+ years of Supervisory/Lead experience required.
- Master's degree in Public Health or Health Science highly
- Population Health Management experience in a Managed Care
- Project Management experience preferred.
- Bilingual in English and in one of CalOptima's defined
threshold language (Spanish, Vietnamese, Arabic, Farsi, Korean,
- Population Health Management program planning and
- Health Effectiveness Data Information Set (HEDIS), National
Committee for Quality Assurance (NCQA), Centers for Medicare &
Medicaid Services (CMS), Department of Health Care Services (DHCS),
and other quality performance standards.
- Performance improvement projects, Plan-Do-Study-Act
- Techniques of project management, quality, and research
- Culture and needs of the socially and ethnically diverse
population CalOptima serves.
CalOptima is an equal employment opportunity employer and makes
all employment decisions on the basis of merit. CalOptima wants to
have qualified employees in every job position. CalOptima prohibits
unlawful discrimination against any employee, or applicant for
employment, based on race, religion/religious creed, color,
national origin, ancestry, mental or physical disability, medical
condition, genetic information, marital status, sex, sex
stereotype, gender, gender identity, gender expression,
transitioning status, age, sexual orientation, immigration status,
military status as a disabled veteran, or veteran of the Vietnam
era, or any other consideration made unlawful by federal, state, or
local laws. CalOptima also prohibits unlawful discrimination based
on the perception that anyone has any of those characteristics or
is associated with a person who has, or is perceived as having, any
of those characteristics.
If you are a qualified individual with a disability or a
disabled veteran, you may request a reasonable accommodation if you
are unable or limited in your ability to access job openings or
apply for a job on this site as a result of your disability. You
can request reasonable accommodations by contacting Human Resources
Disability Management at 657-900-1134.
Keywords: CalOptima, Orange , Supervisor, Population Health Management (Quality Initiatives), Other , Orange, California
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