Category: Curator- Job Hunter

Oversee and direct all population health functions for the assigned business unit based on, and in support of the company’s strategic plan.

• Lead complex projects including affordability analyses around medical and pharmacy expense, business analysis, documentation of business requirements, and defining current/future scope of work.
• Create and manage clinical affordability projects with internal partners, including but not limited to pharmacy, other clinical and network affordability teams, and pilots.
• Create innovative solutions and process enhancements to drive financial and quality success.
• Lead Clinical Model development and process support for the program in all approved state regions to align with the Clinical Model and meet the requirements for the program by supporting reports , technology and core team.
• Identify trends between Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Member Engagement; create programs/pilots to improve engagement with strategic partners.
• Establish the organizations focus and direction regarding models of care that incorporate needs of all lines of business, focusing on quality and operational efficiencies across the organization.
• Create and measure business and clinical outcomes with respect to the provision of clinical support for practice transformation and successful transition of practice to shared savings/risk contract.

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Clipped from: https://www.indeed.com/viewjob?jk=a6bc5c527e6dd58a&tk=1eplo1k6qu3u4801&from=serp&vjs=3

Education/Experience:

Medical Doctor or Master’s degree in Nursing, Therapy, Pharmacy, Public Health/Administration or related field. MBA preferred. 8+ years of clinical experience in the Healthcare industry. Broad understanding of HEDIS and how it is used to drive business growth and efficiencies. Ability to develop, execute and improve clinical programs across large or multiple business units. Ability to identify, create and tracking clinical program opportunities for population health management. Prior experience in an innovation field, long term project, or evidence of driving successful clinical practice innovative solutions.


Licenses/Certification: Unrestricted license as MD, DO, PA, PT, OT, ST, RpH or PN in NC.


For WellCare of North Carolina Health plan: Individual responsible for providing oversight and leadership of all prevention/population health, care management and care coordination programs, including Local Care management plan, AMH model and care management delivered by Local Health Departments. Must reside in North Carolina; More than 5 years of demonstrated care management/population health experience in a large healthcare corporation serving Medicaid beneficiaries; NC licensed clinician (e.g. LCSW, RN, MD, DO).


Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Serve as a liaison to state government entities to improve the legislative and regulatory environment for the state health plan and Centene Corporation

• Assist with the development of state legislative public policy concerning state insurance, Managed Care Organization and Medicare and Medicaid regulations through the initiatives of state legislators and their staff
  
  
• Develop strategic relationships with state legislative policymakers to enhance the health plan and Centene’s role as a partner with the state and to assist in shaping public policy initiatives
  
  
• Identify, evaluate and analyze the impact of state legislative and regulatory issues for state health plan and Centene Corporation and advise management concerning their impact
  
  
• Represent and serve as point person for the state health plan and Centene Corporation to outside trade groups/stakeholders including state AHIP organization, state medical association, state hospital association and related Medicare and Medicaid business vendors
• Represent state health plan and Centene Corporation to state legislators and their staffs
  
  
• Develop and shape legislative policies and strategies through relevant coalitions and issue advocacy campaigns
  
  
• Balance reporting requirements to multiple constituencies including; Centene Corporation regional vice president, state health plan president, chief operating officers and Corporate regulatory and government affairs staff

Clipped from: https://www.indeed.com/viewjob?jk=617fc81fd8835019&tk=1eplo1k6qu3u4801&from=serp&vjs=3

Position Purpose:

Education/Experience:

Bachelor’s degree in Public Policy, Government Affairs, Business Administration or equivalent experience. Master’s or Law degree preferred. 5+ years of related experience. Extensive knowledge of state legislative and regulatory processes. Experience with state legislature, health care trade associations including America’s Health Insurance Plans (AHIP), National Association of Insurance Commissioners (NAIC) and federal and state Medicare and Medicaid laws and regulations. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.


Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law..

The Coalition for Behavioral Health is at the forefront of advancing a robust agenda for behavioral health in New York City and State. The Coalition provides our member agencies mental health and substance use services throughout New York. We serve New York’s behavioral health community by providing policy, advocacy, training, and technical assistance to more than 100 community-based behavioral health providers.

Clipped from: https://www.indeed.com/viewjob?cmp=New-York-HR-Management-Services-LLC&from=iaBackPress&jk=18bf8f2a5170dacf&q=Medicaid&t=Associate%20Director&vjs=3

Summary:

The Associate Director of Policy & Advocacy will work on the Coalition’s Policy & Advocacy team to advance the Coalition’s agenda in the City and State. The individual will be required to work on critical health policy issues, including the mental health impacts of COVID and the opioid overdose crisis. This position reports to the Director of Policy & Advocacy.

Principal Responsibilities:

· Develop regulatory strategy on Medicaid, in partnership with the Director of Policy & Advocacy

· Lead strategy on one of the following key behavioral health policy areas: children, older adults, supportive housing

· Cultivate relationships with key government officials and member agencies

· Testify at hearings and represent the Coalition at external meetings

· Lead at least one Coalition committee, working with member leadership to develop an agenda create compelling meetings and ensure member engagement

· Write white papers, bill memos, regulatory comments, and other policy materials

· Collaborate on the development of overall strategy agenda and policy priorities

· Expected to work effectively independently and as part of a team

· Other duties as assigned

Qualifications and/or Skills:

· Knowledge of behavioral health and health policy, ideally with expertise in one of the following areas: children, older adults and/or supportive housing

· Ability to build relationships with external stakeholders

· Excellent writing skills

· Familiarity with city and state policymaking process

· Willingness to register as a lobbyist

Education and Experience

· Bachelor’s degree in a relevant field; master’s degree preferred

· At least five years relevant experience

· Previous regulatory policy experience, either in government or at an advocacy organization

Benefits

The Coalition offers a competitive salary and benefits including a pension plan, health, dental, vision and life insurance, STD/LTD, paid vacation and sick leave, and other benefits

EOE

The Coalition for Behavioral Health is an Equal Opportunity Employer and offers equal opportunities for employment for all qualified applicants consistent with federal, state, and local laws.

Job Type: Full-time

Pay: $65,000.00 – $85,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Flexible schedule
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• Monday to Friday

Company’s website:

• www.coalitionny.org

Work Remotely:

• Yes

COVID-19 Precaution(s):

• Remote interview process