Hedis Project Coordinator Jobs in Riverside, CA (NOW HIRING)

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Under the direction of the Vice President of Population Health, the Senior Director, Population Health provides leadership in the development and implementation of the IEHP Population Health strategy and program, with direct oversight over population health management regulatory requirements related to low-risk Members. The Senior Director works closely with key stakeholders and partners to ensure IEHP compliance with population health requirements under NCQA, Medi-Cal, and Covered California. The position directly supervises the IEHP Health Education, Promotion, and Prevention Department, the Community Behavioral Health Department, as well as the Population Health Unit, and coordinates activities with other IEHP leaders and external partners. The position is key in our partnership work with county public health departments on initiatives such as Community Health Assessments and Community Health Improvement efforts. The position also oversees partnership meetings and MOUs related to Population Health, as required in the 2024 Medi-Cal contract. The position may also have a key role in IEHP strategic plan initiatives under Optimal Care and Vibrant Health.
The Senior Director, Population Health reports to the Vice President, Population Health & CalAIM. This classification is characterized by the responsibility to work collaboratively with senior management teams at IEHP and partner agencies, both locally and at the State/Nation level, to ensure that the strategic priorities of the organization are met, with a focus on improving population health in the Inland Empire. The Senior Director is motivated to work in a setting with a social mission.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

1. Develop and implement IEHP’s population health management strategy and approach. 
2. Collaborate with key internal and external leaders, which includes conducting periodic population needs assessments, implementing strategies to systematically move farther upstream to impact the social determinants of health for IEHP members, identifying health disparities and system gaps in care, as well as ensuring that the health delivery system is focusing on evidence-based interventions and programming for the various segments of the population.
3. Participate in the development and implementation of evidence-based approaches to address social determinants of health and community health assessment/improvement projects, in collaboration with internal departments, local and state agencies, local stakeholders, and funders.
4. Oversee the department of Health Education, Promotion, and Prevention and the Community Behavioral Health Department and their functions, staff, and programs.  Potentially other departments pending restructure.
5. Oversee the department of Population Health and its functions, staff, and programs, inclusive of the Health Services Evaluation Team.
6. Serve as a representative and spokesperson for IEHP in support of integration and population health activities in the Inland Empire with key county partners as well as State and National organizations and conferences.
7. Ensure IEHP compliance with population health management regulatory requirements under NCQA, CalAIM/Medi-Cal 2024 contract, and Covered California.
8. Oversee partnership joint operating meetings (ex. with counties) and MOUs related to population health as required in the 2024 Medi-Cal contract.
9. May have a lead role in IEHP Strategic Plan initiatives in Optimal Care and Vibrant Health.
10. Participate in State and industry work groups such as DHCS, DMHC, CHCF, NCQA, ACAP and CAHP to expand IEHP’s influence on benefit design, regulations, and policy direction.
11. Hire, train, and manage support staff, while monitoring and evaluating outcomes. Conduct performance reviews of each team Member within IEHP guidelines.
12. Perform any other duties as required to ensure Health Plan operations and department business needs are successful.

Education & Requirement

• Ten (10) years of experience in a population health-related role, inclusive of at least five (5) years in a health plan or health system required
  • Experience in public health programming, research and evaluation, community collaborative work and/or policy analysis preferred

• Master’s degree in a related field from an accredited institution required

  • In lieu of a Master’s degree, both items listed below are required:

    • Bachelor’s degree in a related field from an accredited institution

    • Possession of an active, unrestricted, and unencumbered clinical licensure issued by the appropriate California State Board are required (RN, LCSW, LMFT, MD/DO or similar)

Key Qualifications

• Administrative practices and procedures (including but not limited to quality assessment and improvement, program development and evaluation, evidence-based practice guidelines and pathways; principles of effective supervision and organization)
• Understanding of Managed Care Plan regulatory requirements
• Microcomputer applications such as Microsoft Office, Word, Excel, and Access helpful

Start your journey towards a thriving future with IEHP and apply TODAY!

This position is on a hybrid work schedule. (Monday & Friday - remote, Tuesday – Thursday onsite in Rancho Cucamonga, CA.)