Remote Clinical Program and Population Health Strategist-Government Programs

Remote Office

Now Hiring: Remote Clinical Program and Population Health Strategist-Government Programs Summary:

Presbyterian is hiring a skilled Clinical Program and Population Health Strategist-Government Programs to join our team.

Type of Opportunity: Full time

Remote Workers New Mexico

Work Shift: Days (United States of America)

The Clinical Program & Population Health Strategist - Government Programs is responsible for advancing population health strategy for ACA, Medicaid, and Dual Eligible Special Needs Plan (D-SNP) populations. This role aligns with Presbyterian's integrated delivery system (IDS) model and Health Value strategy, partnering across the health plan, medical group, and care delivery system.

The Strategist translates enterprise population health priorities into product-specific strategies, clinical program designs, and a prioritized Clinical Initiative Portfolio. This role influences execution through cross-functional partnerships but does not directly manage program operations or vendor performance.

Government Programs Population Health Strategy

• Develop population health strategies for ACA, Medicaid, and D-SNP populations aligned with enterprise priorities
• Ensure alignment with regulatory requirements and product-specific goals
• Define success metrics aligned with HEDIS, Stars, risk adjustment, and utilization goals
• Define target populations, program goals, and success measures
• Partner with program and operational leaders to support implementation and scaling

Provider Strategy & Performance Enablement

• Provide input into value-based care models and provider performance strategies
• Serve as liaison to Government Programs teams
• Ensure alignment between benefit design, clinical programs, and population health outcomes
• Collaborate with analytics, network, and operations teams
• Use data to identify trends, gaps, and opportunities

Regulatory & Compliance Strategy

• Ensure strategies align with CMS and Medicaid requirements

Health Equity & Community Integration

• Embed health equity into all strategies and program designs
• Partner with community organizations and internal teams

Medicare Stars and HEDIS performance

• Medicaid quality measures
• Clinical Initiative Portfolio performance and ROI
• Health equity outcome measures

Reports to: Vice President, Population Health, Provider Strategy and Performance

Key partnerships: Government Programs Product Owners, Provider Strategy, Analytics, Network Management, Compliance, Community Health

Collaborates across Presbyterian Health Plan and Medical Group

Bachelor's degree required; Master's degree (MPH, MHA, MBA, or related) preferred

• ~5-10+ years of experience in population health, healthcare strategy, or clinical program design
• ~ Strong understanding of HEDIS, Stars, risk adjustment, and utilization drivers
• ~ Data-driven decision making
• ~ Health equity focus

Benefits

• medical
• dental
• vision
• short-term and long-term disability
• group term life insurance
• other optional voluntary benefits

Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and commercial health plans.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services