Manager of Population Health & Community Development

Department:                 Care & Population Health Management

Reports To:                  Director of Care & Population Health Management

Status:                         Full Time Exempt

Hours:                          Monday – Friday

Supervision:                Population Health & Community Development Team (5 team members)

Summary:        The primary role of PrimeWest Health’s Manager of Population Health & Community Development (PHCD) is leading the PHCD Team within PrimeWest Health’s Care & Population Health Management department. This includes overseeing and continually refining PrimeWest Health’s population health management strategy and community development efforts to help our members attain optimal health and fuller lives. The PHCD Manager is responsible for coordinating intra- and interdepartmental population health and health equity strategies and activities, as well as developing and directing population health, health equity, and community development strategies within the PHCD Team. The position is also responsible for developing and directing PrimeWest Health’s health promotion efforts, managing the PrimeWest Health Community Reinvestment Program (CRP) (grants-making program), directing our community organization and development efforts at the local level within our service area counties, representing the organization in community-organized health improvement initiatives affecting PrimeWest Health members, and performing regulatory compliance responsibilities related to population health management, including regulatory reporting. This position is afforded a great deal of autonomy in overseeing and coordinating all operational and administrative responsibilities associated with PrimeWest Health’s population health management and community development activities and, therefore, requires a high degree of initiative, self-motivation, creative and analytical thinking, and independent decision-making.

These person-centered, data-driven, outcome-oriented activities are designed to achieve four goals, which PrimeWest Health calls the four dimensions of optimal health care, or 4D: improving our members’ health care experience (care outcomes, care quality, member satisfaction), improving member population health, achieving health equity across our entire member population, and improving the value of health care provided to our members. PrimeWest Health pursues these objectives by leveraging our integrated relationship with county Public Health and Human Services agencies and contracted health care providers to optimally coordinate the timely provision of medical, behavioral health, public health, and social services around the individual member’s assessed health care needs and social determinants of health (SDOH).

Our population health and community development activities emphasize reducing health disparities, health care disparities, and SDOH risks that exist among population groups within the PrimeWest Health member population and achieving greater health equity across our member population, which includes members enrolled in our Families and Children, MinnesotaCare, Minnesota Senior Health Options (MSHO), Minnesota Senior Care Plus (MSC+), and Special Needs BasicCare (SNBC) programs. The Manager of PHCD carries out individual and team responsibilities and designs population health management, health equity, and community development efforts in conjunction with PrimeWest Health’s Strategic Plan in compliance with State and Federal Medicaid and Medicare managed care regulations and contractual obligations.

Reporting Accountability This position is responsible for the PHCD Team meeting the following regulatory, contractual, or other requirements on behalf of PrimeWest Health:

1. All population health management projects, audits, and compliance reports for the State and Federal governments for all PrimeWest Health programs, including drafting, updating, and submitting the PrimeWest Health Model of Care (MOC) descriptions for PrimeWest Health’s MSHO and SNBC programs
2. Reporting accountability including, but not limited to, all regulatory reports assigned to the PHCD Team listed in PrimeWest Health’s Regulatory Reporting Grid as shown on PrimeWest Health’s internal communications website (Confluence)
3. All National Committee for Quality Assurance (NCQA) reporting assigned to the PHCD Team
4. CRP grantee project progress and outcome reporting, including grantee reporting compliance oversight

Role and Key Responsibilities Assist the Director of Care & Population Health Management and PrimeWest Health staff in the following as needed:

1. Supervise PHCD Team including hiring, evaluating, and initiating corrective action per PrimeWest Health personnel policies and procedures Continually improve our population health management and health equity activities to help PrimeWest Health achieve our 4D objectives by routinely assessing the effectiveness of these activities; and by following National Committee for Quality Assurance (NCQA) population health management models and standards, keeping apprised of the latest research and best practices nationally and statewide in the areas of population health management, health equity, and SDOH, and presenting ideas to the Senior Executive Management team for incorporation into PrimeWest Health’s population health management strategy Implement community organization efforts and development initiatives at the local level with targeted member populations and communities within the PrimeWest Health service area, including engaging local health care providers, human services providers, and community resource agencies in order to support and collaborate on local PrimeWest Health population health improvement efforts Organize and conduct local population health improvement events Develop CRP grant initiatives designed to help PrimeWest Health’s 4D objectives, including Request for Proposal (RFP) development, developing proposal scoring criteria, organizing and coordinating grant proposal review, and making grant award recommendations to the Chief Executive Officer (CEO) to present to the PrimeWest Health Joint Powers Board (JPB) Ensure PHCD Team strategic objectives and strategy timelines are achieved within a defined budget and in a timely, effective, and efficient manner. Maintain positive communication with other key internal units to ensure objectives and strategies are aligned. Continually analyze PrimeWest Health member population health data for opportunities to improve population health and health equity and address SDOH Communicate initiatives to relevant staff. Provide staff with tools, training and education, direction, and motivation to perform their responsibilities at the highest levels. Oversee PrimeWest Health policies and procedures related to population health management and health equity, including annual review Maintain knowledge of regulatory and contractual requirements and conduct risk management activities to ensure the PHCD Team’s compliance with applicable regulations and requirements Oversee measuring and evaluating the progress of member population health Communicate and coordinate PHCD Team activities and initiatives with other PrimeWest Health departments Maintain positive working relationships and regular communication with county Public Health and Human Services agencies and health care providers to ensure their active support for and coordination with PrimeWest Health’s population health improvement and health equity efforts Ensure annual updates to the PrimeWest Health Quality Plan are completed in compliance with regulatory and contractual requirements and current community standards for quality activities Manage and oversee quality improvement activities relative to population health management in collaboration with the Director of Quality & Utilization Management on all phases of Performance Improvement Projects (PIPs) Coordinate PrimeWest Health’s internal Health Equity Committee Co-coordinate PrimeWest Health’s Population Health & Cost Improvement Committee Help staff the PrimeWest Health JPB’s Health Equity Council Participate in the PrimeWest Health County Public Health & Human Services Directors Committee Participate in the PrimeWest Health Quality & Care Coordination Committee Actively participate in the PrimeWest Health Leadership Team Develop and manage the PHCD Team budget Maintain and protect members’ protected health information (PHI) Collaborate with the Director of Business IT & Claims Administration regarding information technology systems used by PrimeWest Health as they relate to population health management activities Represent PrimeWest Health at monthly and/or quarterly Minnesota Department of Human Services (DHS) workgroup meetings and ad hoc workgroup meetings with DHS and other health plans Serve as PHCD Team representative for interdepartmental discussions
    

General PrimeWest Health Responsibilities

1. Abide by the PrimeWest Health Code of Conduct Comply with all PrimeWest Health policies and procedures Comply with the Health Insurance Portability and Accountability Act (HIPAA) and all other privacy laws Be familiar with building safety procedures and alert maintenance if something requires attention Keep public areas of the department and office neat and clean Conduct other responsibilities and activities as needed and assigned

Professional Competencies

1. Knowledge of and skills in population health management, community organization and development, health promotion, culturally competent care, care system navigation, health coaching, care coordination, case management, and chronic condition management and population health management, including the concepts embraced by the NCQA population health management model Experience working in or with health care, human services, and/or community SDOH resource agencies in areas with diverse population groups (race, ethnicity, language, income level, age, gender identification, sexual orientation) and that provide care to those populations; experience with culturally appropriate care Knowledge of: a) NCQA population health management model and standards; and b) applicable Federal and State of Minnesota laws, rules, and regulations governing health services provided to members through Medicare, Medicaid, and managed care programs Ability to perform health care data analyses, plan and organize, promote member and family autonomy, maintain confidentiality, and maintain files and records Comfortable with traveling and driving alone by automobile to remote rural Minnesota locations Skills in group development and facilitation, community organization and development, health promotion, data analysis, public speaking, and continuous quality and process improvement Experience in organizational leadership, management including direct employee supervision, conflict management, and handling difficult people

Educational Requirements and Required Qualifications

1. Bachelor’s degree or higher in one or more of the following areas: community health, public health, health promotion and prevention, sociology, social work, psychology, and/or mass communications Practical experience in one or more of the following areas: population health management, health promotion and prevention strategy and campaign development/implementation, community health, public health, social work, complex or chronic condition population management, and/or community organization Experience in analyzing and utilizing data for continuous quality, process, program, and strategy improvement Work experience in management or employee supervision Demonstrated knowledge or experience in providing culturally competent care and working with culturally diverse populations Demonstrated knowledge of, and proficiency in, Word, Excel, and Outlook required Flexibility and ability to handle multiple tasks. Demonstrated organizational skills and attention to detail. Ability to work effectively with a variety of people both within and outside of the organization. Excellent written and verbal communication skills, including public speaking. Ability to sit at a desk or computer station most of the time. Ability to occasionally lift and/or carry such articles as file folders and small boxes up to 20 pounds. Some travel, including overnight travel, required.

Appropriate Licensure and Certification Requirements – N/A  

Collaborative Efforts with Other Departments

1. Administrative Services Business IT & Claims Administration Corporate Compliance & Auditing Information Systems & Technology Member & Provider Services Operations Pharmacy Management Quality & Utilization Management

Supervision

1. Act as supervisor to PHCD Team employees
2. Comply with all PrimeWest Health personnel policies and procedures
3. Model leadership, integrity, and honesty in communications with other departments and PrimeWest Health staff

This position description is not to be construed as an exhaustive statement of essential functions or responsibilities.

Location: Alexandria, Minnesota – This position offers the possibility for remote/hybrid work

Employment to begin as soon as possible.

PrimeWest Health is an Equal Opportunity Employer Committed to Diversity, Equity, and Inclusion