Business Overview

As part of the bold vision to deliver the “Next Generation” of managed care in Ohio Medicaid, OhioRISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems.

The Population Health Specialist(PHS)leads initiatives to advance health outcomes and reduce disparities for the OhioRISE population. This role applies quality improvement sciencetolead effortsimprovinghealth outcomes for OhioRISE members byidentifyingdisparities and implementing targeted interventions.The PHS analyzespopulation health data to uncover trends, gaps in care, and opportunities for system-level improvement.Designs and executes quality improvement projects to address identified needs by collaborating with diverse stakeholders,including internal care coordination teams, hospital systems, the Ohio Department of Medicaid, Case Western Center of Excellence, and Care Management Entities. Monitors, evaluates, and reports on the effectiveness of population healthinterventionsto ensure measurable impact.Servesas a quality improvementmethodologysubject matter expert within the OhioRISE program.

This is a full time telework positionwithoccasionaltravelrequired(within Ohio)asdeterminedby business need-residingin Ohio is stronglypreferred

Primary Responsibilities:

• Using the Institute for Healthcare Improvementmodel,thisindividual will lead population health projectsto improve health outcomes for the OhioRISE populations.

• Ensuretimelymanagement and continualupdating ofdocumentation to reflect ongoing changesand outcomes Oversee and drive consistent progress in intervention testing.

• Analyze complex data sets toidentifyemerging trends and design, test, and evaluate targeted interventions for improvement.

• Servesas a subject matter expert on quality improvement methodologies andtools.

• Deliver presentations to internal and external stakeholders

• Collaborate with the Ohio Department of Medicaid,Case Western Center of Excellence,Care Management Entities,internalteams andotherkey stakeholders, including Medicaid managed care plans, community organizations,members/families,and healthcare providers, to develop and implement population health strategies andinterventions

• Support quality improvement initiatives as needed.

• Provides necessary updates as needed and supporting documents for state RFP, NCQA and EQROreviewsand proposalsubmissions.

• Assistingin ensuring the Plan meets all regulatory requirements as outlined in the Provider Agreement and other accreditingagenciespolicies.

• Under the direction of the Director of Population Health, develops the annual Population Health Strategy, including assessments on enrollee participation and program impact.

• Ability to travel up to10% of the time inOhioto office and state meetings.

• Musthave reliable transportation.Valid/active driver’s license, and proof of vehicle insurance.

• Performsadditionalresponsibilities andtasks asrequiredto support team and organizationalobjectives

Required Qualifications:

• Minimum 3years experiencein health care or public health with apreferred focus on quality improvement, population health, care management, social work, or behavioral health.

• At least 1 year experience in population health or quality improvement role

• Proficient in Microsoft Word, Excel, and PowerPoint

Preferred Qualifications

• Experience with Improvement methodologies (Six Sigma, Lean, IHI Model)is strongly preferred.

• Embraces change andremainsflexible when faced with evolving priorities or ambiguous situations.

• Strong analytical, communication, and project management skills.

• Self-motivated anddemonstratedability to work independently

• Abilityto build collaborative relationships with internal and external stakeholders.

• Experience working with Medicaid populations is strongly preferred.

Education:

• Bachelor’s degree in public health, health administration, social work, ora relatedfield, or equivalent work experience.