• Amerihealth Caritas Health Plan
  • Philadelphia , PA
  • Scientific Research
  • Full-Time
  • 1103 Market St


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Responsibilities:

* The Clinical Lead reporting into the Director of New Business Support will participate in the design, documentation and implementation of Clinical and/or Quality aspects of the population health model to new markets.

* Participate in designing an approach (including clinical partnerships and solutions focusing on specific market needs and pain points).

* Participate in market entry activities, including but not limited to provider meetings and development of partnership opportunities.

* Works with the proposal team to develop content and proof points related to the clinical and/or quality aspects of new business proposals to support successful RFP responses.

* Provide in-market support for hiring, training, readiness review, go-live and stabilization for clinical and/or quality programs needed for new business.

* Develop licensure documents, policies procedures and program descriptions.

* Serve as a mentor/resource for new business clinical leaders to ensure successful completion of the stabilization phase.

* Ensure new market population health workflows and reporting are reflective of enterprise population health strategy along new market needs and proposal commitments.

Education/Experience:

* Bachelor's Degree Bachelor's Degree (Business of Healthcare) or equivalent work related experience.

* Registered Nurse preferred.

* Five or more years of progressive experience (including staff management) in a managed care environment. Experience with Managed Medicaid programs highly desirable.

* Experience in Quality and Care Management and Utilization Management program design and implementation. Should include experience in writing policies and program design documents

* Strong oral and written communication skills.

* Excellent Organizational skills.

* Understanding Population Health strategy.

* Project Management capabilities.

* Knowledge of work flows preferred.
Associated topics: bacteria, biomedical, drug, drug development, food scientist, healthcare, medical, microbiological, microbiology, toxicologist

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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