Market Clinical Director Population Health | South Carolina

Responsibilities

The Market Clinical Director of Population Health is responsible for market-specific clinical operations, supervising prenatal UM and ICM staff, and ensuring all market activities conform to enterprise program descriptions, policies, and procedures.

• Oversight of execution of market-specific clinical programs, including prenatal UM, CM, Foster Care, and Bright Start.
• Assures compliance of program execution with enterprise policies
• Monitors performance metrics across multiple LOBs and assures that appropriate action is taken to address performance opportunities consistent with enterprise policies.
• Responsible for market-specific contract and NCQA accreditation compliance related to Population Health Clinical Operations.
• Supervises market-specific Population Health Clinical Operations staff.

Education / Experience :

• Bachelor's degree required in Nursing or healthcare-related field required
• Master's preferred or equivalent work-related experience.
• Clinical license is required, RN is preferred. LCSW or BH equivalent advanced licensure can be considered.
• CCM certification preferred within 2 years of hire.
• Three to five years of progressive management experience (including staff management) in a managed care environment.
• Experience with Managed Medicaid clinical programs is highly desirable.
• Experience with Foster Care is highly desirable.
• Knowledge of LTSS programs is highly desirable.
• Management experience with Case Management programs preferred.
• Experience in CM design and implementation is preferred. This should include experience in setting, communicating, and implementing strategic direction.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable being themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential.

We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace.

Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

Generous paid time off and paid volunteer time off.

Employer-matched 401(k) and additional non-elective contributions, starting on day one.

Medical, dental, and vision plans with coverage starting on day one.

Employee assistance programs, fitness reimbursements, nutrition counseling, and more.

Employer-paid life insurance, with opportunities to purchase additional coverage.

Employer-paid short-term disability coverage and long-term disability coverage.

Tuition assistance, including reduced tuition at certain schools.

Financial assistance with adoption, including paid time off.

Flexible spending and health savings accounts to pay for qualified expenses.

Discount programs on entertainment, travel, and more.