Population Health Director
1 day ago
Phoenix
Job Description ABOUT ADOBE Adobe Population Health (APH) is a women-owned health solutions company founded in 2018 with a mission of positively impacting the lives we touch. Headquartered in Phoenix, AZ, with satellite locations across multiple states, APH fosters a culture rooted in inclusivity, human kindness, and high-quality care. Recognized by Inc. 5000 as one of America’s Fastest-Growing Private Companies and honored for a fifth consecutive year as a “Best Place to Work” by the Phoenix Business Journal, APH continues to expand its reach and impact. APH partners with health plans, providers, hospitals, and families to deliver tailored programs including case management, in-home and in-clinic wellness assessments, preventative care, transitional care, and social services. As one of the nation’s few fully integrated healthcare organizations, APH delivers comprehensive, coordinated medical and social support through a wide range of specialized service lines. With continued growth on the horizon, APH is seeking mission-driven individuals who are passionate about improving health outcomes and supporting those in need. POSITION PURPOSE The Director of Population Health is a senior leadership role responsible for overseeing population health programs, community-based care coordination, and clinical quality performance with a primary focus on improving HEDIS and Medicare STARS outcomes. This role bridges operational execution and quality performance strategy by translating organizational goals into actionable workflows, performance improvement initiatives, and frontline care delivery standards. The Director is accountable for leading HEDIS/STARS-focused Quality Improvement initiatives, optimizing care coordination operations, supporting utilization reduction strategies, and ensuring compliance with NCQA, URAC, QAPI, and health plan requirements. This role works closely with executive leadership while maintaining direct operational oversight of teams and program performance. This position works closely with our Field Manager and Assistant Director of Community Care Services and reports to our Sr Director of Integrated Care Services. In the Director role, you will be reporting to the Phoenix office (conveniently located off the 51, Glendale Ave. and 16th St.) three days per week with an option to work remotely two days per week. In this role, you may be responsible for traveling throughout the APH-supported states, including but not limited to AZ, LA, NV, NM, and OR DUTIES & RESPONSIBILITIES Population Health & Program Leadership • Provide senior management leadership for population health programs and care coordination operations., • Implement organizational population health strategies and translate performance goals into operational execution plans., • Collaborate with Quality, Compliance, Analytics, and Operations teams to support organizational performance targets., • Participate in health plan performance meetings and quality improvement discussions., • Lead the design and execution of Quality Improvement initiatives focused on improving HEDIS and Medicare STARS scores., • Develop annual HEDIS/STARS operational workplans and intervention strategies., • Monitor measure performance trends and identify priority opportunities for gap closure., • Partner with frontline teams to operationalize outreach strategies, documentation standards, and quality workflows., • Oversee real-time performance tracking and adjust intervention strategies throughout the measurement year., • Support supplemental data submissions, medical record retrieval efforts, and audit readiness activities., • Provide direct operational oversight of community-based care coordination teams including care coordinators, navigators, transition specialists, and field staff., • Ensure consistent delivery of high-quality in-home and community-based services that support quality and utilization performance goals., • Support Assistant Directors and field leadership with staffing models, productivity expectations, and performance coaching., • Address escalated member care issues, transition of care challenges, and SDOH barriers impacting outcomes., • Monitor utilization trends including inpatient admissions, ED visits, and readmissions., • Implement targeted interventions to reduce avoidable utilization while maintaining quality standards., • Support Health Benefit Ratio (HBR) improvement through population health initiatives and care coordination strategies., • Use claims, clinical, and operational data to identify improvement opportunities., • Oversee dashboards tracking HEDIS, STARS, utilization, productivity, and quality outcomes., • Lead recruitment, onboarding, training, and ongoing development of management and frontline staff., • Promote accountability, performance excellence, and continuous improvement across teams., • Conduct leadership meetings and provide routine performance coaching., • Collaborate with internal departments including Quality, Compliance, Data Analytics, Provider Relations, and Operations., • Coordinate with external provider partners and community organizations to support quality improvement and care gap closure initiatives., • Support accreditation and audit activities as needed., • Other duties as assigned by management. SKILLS & QUALIFICATIONS • Five (5)years of healthcare, population health, or clinical operations experience., • Five (5)years of progressive management experience in quality improvement, population health, or care coordination., • Demonstrated experience improving HEDIS and Medicare STARS performance., • Strong understanding of Medicare Advantage, Medicaid, and value-based care models., • Experience managing multidisciplinary teams across multiple states or regions., • Strong analytical and operational problem-solving skills., • Excellent communication, leadership, and stakeholder collaboration skills., • Proficiency with EMR systems (Salesforce preferred) and Microsoft Office Suite., • Ability to manage multiple initiatives in a fast-paced environment., • Willingness to travel as needed EDUCATION, LICENSES, & CERTIFICATIONS • Bachelor’s degree required (healthcare administration, nursing, public health, social work or related field)., • Master’s degree preferred (MSN, MHA, MPH, MBA, MSW)., • CPHQ or CCM certification preferred., • Project Management certification a plus. BENEFITS & TOTAL REWARDS • Paid Orientation and Training, • Insurance – Medical, Dental, Vision, and Life, • 401k Plan – 3% match, • Employee Assistance Program, • Tuition Reimbursement, • Continued Education Support, • Mileage Reimbursement (if applicable), • Referral Bonuses, • Paid Holidays (9days), • Flexible Time Off, • Paid Volunteer Hours CHARACTER & COMPETENCIES • Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce., • Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethics; Upholds organizational values., • Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events., • Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments., • Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things., • Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions., • Problem-Solving - Identifies and resolves problems promptly; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem-solving situations; Uses reason even when dealing with emotional topics., • Professionalism - Tactfully approaches others; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through with commitments., • Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed. PHYSICAL DEMANDS & WORK ENVIRONMENT • Occasionally required to stand., • Occasionally required to walk., • Continually required to sit., • Occasionally required to climb, balance, bend, stoop, kneel, or crawl., • Continually required to talk or hear., • While performing the duties of this job, the noise level in the work environment is usually moderate., • Must be comfortable with working in a variety of conditions, including members’ homes, physicians’ offices, cold conditions, and hot conditions., • The employee may occasionally lift and /or move more than 30 pounds., • Must be able to physically perform the essential duties of the position which include lifting 30 lbs., transporting materials, stooping,kneeling, crouching, reaching, use of hands, balancing, walking, standing, talking, hearing, and typing. EQUAL EMPLOYMENT OPPORTUNITY APH is an Equal Opportunity Employer where all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.