Director of Population Health (Operations and Clinical Support)

Key Responsibilities

Population Health Strategy & Execution

• Develop and implement a comprehensive population health strategy across STAR Kids and STAR/CHIP populations 
• Design and scale targeted interventions, outreach campaigns, and screening programs to improve outcomes and reduce cost of care 
• Establish measurement frameworks to monitor performance, including HEDIS and quality metrics 
• Partner with executive leadership to drive system-wide population health initiatives 

Regulatory Compliance & Quality Oversight

• Ensure compliance with all state and federal regulatory requirements, including NCQA standards 
• Oversee audits, reporting, and performance improvement initiatives across care coordination programs 
• Monitor timeliness, accuracy, and effectiveness of member outreach, complaints, and regulatory submissions 

Cost Management & Care Optimization

• Lead initiatives to reduce avoidable costs of care, including readmissions and inefficient care delivery models 
• Partner with internal teams and external providers to optimize transitions of care and specialty programs 
• Drive process improvements that enhance operational efficiency and financial performance 

Social Determinants of Health & Health Equity

• Develop and lead strategies addressing social determinants of health and health disparities 
• Build and maintain partnerships with community organizations to support member wellbeing 
• Utilize data and analytics to identify at-risk populations and implement targeted interventions 

Leadership & Collaboration

• Collaborate cross-functionally with clinical, operational, and executive leaders across the organization 
• Serve as a thought leader in population health and community engagement 
• Lead, mentor, and develop team members while fostering a culture aligned with TCH values 

Qualifications

Education

• Bachelor’s degree in Nursing or Social Work (required) 
• Master’s degree in Nursing (preferred) 

Experience

• Minimum of 5 years of supervisory or formal leadership experience (required)
• At least 4 years of progressively responsible experience in population health, community/public health, ambulatory care, or healthcare administration (required)
• Experience with NCQA accreditation processes and requirements (preferred)