Population Health Manager

Population Health Manager

The Population Health Manager is responsible for the day-to-day management and oversight of Population Health staff and initiatives focused on improving value-based care performance, quality outcomes, preventive care delivery, and population health metrics across the organization. This position supervises Population Health Advocates and related staff responsible for care gap closure, Annual Wellness Visit (AWV) outreach and completion, quality measure performance, and data-driven interventions.

Working under the direction of the Population Health Director, the Population Health Manager serves as a key liaison between Population Health, clinic leadership, centralized departments, and executive leadership to ensure successful implementation of organizational quality and population health strategies. The Population Health Manager collaborates closely with Health Center Managers (HCMs), centralized scheduling leadership, clinical leadership, and other operational stakeholders to drive improvements in quality metrics, patient engagement, and value-based care performance.

Essential Duties and Responsibilities

• Provide direct supervision, coaching, development, and performance management for Population Health staff, including Population Health Advocates and other assigned team members.
• Establish work priorities, monitor productivity, and ensure timely completion of population health initiatives.
• Conduct regular team meetings, performance reviews, and staff development activities.
• Promote a culture of accountability, collaboration, and continuous improvement.

• Oversee daily operations related to value-based care and population health initiatives.
• Direct efforts to identify, prioritize, and close care gaps for preventive, chronic disease, and quality measures.
• Coordinate and monitor Annual Wellness Visit (AWV) outreach, scheduling, completion rates, and follow-up activities.
• Ensure effective workflows are in place to improve quality measure performance across all clinics.
• Monitor organizational performance against established quality benchmarks and value-based contract goals.
• Collaborate with clinical and operational leaders to implement strategies that improve patient outcomes and quality scores.

• Review and evaluate quality and utilization data received from Managed Care Organizations (MCOs), payers, and internal reporting systems.
• Identify trends, opportunities, and barriers impacting quality performance and population health outcomes.
• Partner with the Population Health Director to develop targeted intervention strategies based on data analysis.
• Prepare and present performance reports, dashboards, and recommendations to leadership as requested.
• Monitor the effectiveness of implemented initiatives and recommend adjustments as needed.

• Serve as the primary liaison between Population Health staff, individual health centers, centralized departments, and organizational leadership.
• Collaborate with Health Center Managers (HCMs) to implement clinic-based quality improvement initiatives.
• Work closely with centralized scheduling leadership to support outreach efforts, appointment access, and Annual Wellness Visit completion.
• Partner with clinical leadership and centralized clinical managers to ensure effective implementation of population health workflows.
• Facilitate communication and coordination among departments to support organizational quality and value-based care objectives.

• Assist the Population Health Director in developing and implementing population health strategies and operational plans.
• Participate in the development of workflows, policies, and procedures that support quality improvement and value-based care initiatives.
• Support organizational readiness for payer quality programs, audits, reporting requirements, and performance improvement initiatives.
• Identify opportunities to enhance patient engagement, preventive care utilization, and chronic disease management outcomes.

• Ensure compliance with organizational policies, payer requirements, regulatory standards, and quality reporting guidelines.
• Maintain confidentiality and security of patient information in accordance with HIPAA regulations.
• Support continuous quality improvement efforts and organizational accreditation activities.

Education and Experience

• Bachelor's degree in Healthcare Administration, Public Health, Nursing, Business Administration, or related field required (or equivalent experience)
• Minimum of three (3) years of healthcare management or supervisory experience required.
• Experience in population health, quality improvement, value-based care, managed care, care coordination, or healthcare operations required.

Preferred

• Master's degree preferred.
• Federally Qualified Health Center (FQHC) experience preferred.
• Experience managing staff and leading cross-functional initiatives preferred.

Knowledge, Skills, and Abilities

• Strong understanding of population health management, quality measures, and value-based care programs.
• Knowledge of HEDIS, Medicare Annual Wellness Visits, preventive care measures, and payer quality programs.
• Ability to analyze complex data and translate findings into actionable strategies.
• Strong leadership, organizational, and project management skills.
• Excellent interpersonal, communication, and relationship-building abilities.
• Ability to work collaboratively with clinical, operational, and executive leadership.
• Proficiency in electronic health records (EHRs), reporting systems, Microsoft Office applications, and data analysis tools.
• Ability to manage multiple priorities in a fast-paced healthcare environment.

Physical Requirements

• Ability to sit, stand, walk, and use office equipment for extended periods.
• Ability to travel between health center locations as needed.
• Ability to lift up to 25 pounds occasionally.

This description lists the major duties and requirements of the job and is not all-inclusive. Applicants may be expected to perform job-related duties other than those contained in this document and may be required to have specific job-related knowledge and skills.