Position Description

Director Market Clinical Population Health [ RN, LCSW, or BH ]
Location Newark, DE
Primary Job Function Medical Management
ID** 21274
Apply Now

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

The Market Clinical Director, Population Health is responsible for market specific clinical operations supervising Care Management ensuring all market activities conform to enterprise program descriptions, policies and procedures.

  • Oversight of execution of market specific clinical programs including Bright Start.
  • Assures compliance of program execution with enterprise policies.
  • Monitors performance metrics  and assures that appropriate action is taken to address performance opportunities consistent with enterprise policies.
  • Responsible for market specific contract and accreditation compliance related to Population Health Clinical Operations.
  • Supervises market specific Population Health Clinical Operations staff.

 

Education/Experience:

  • Bachelor’s degree: Registered Nurse, Licensed Clinical Social Work, or  Behavorial Health equivalent. Master’s degree preferred.
  • Required valid, unrestricted RN Delaware license. OR
  • Required valid, unrestricted Delaware licensed in a Behavioral Health specialty [i.e. LCSW or LPC].
  • 5 + years proven direct people management experience.
  • 3-5 years progressive Managed Care (Medicaid clincal programs) experience.
  •  Preferred 3-5 years experience in Case Management  and Utilization Management program design, to include strategic direction communication and implementation. 
  • Must be administratively savvy using MS Office (Excel required) and Clinical /Healthcare Systems.

Note:  Presently all of our AmeriHealth Caritas Family of Companies associates are working remotely due to the Pandemic.   This role/department will return to the Delaware office when it is safe. 

Back Apply Now