Vice President, Population Health WellCare North Carolina Health Plan

Raleigh, NC

Key Info

full-time

Non clinical

WellCare North Carolina Health Plan is a subsidiary of Centene Corporation.

  • Oversee and direct all population health functions for the assigned business unit based on, and in support of the company’s strategic plan.
  • Lead complex projects including affordability analyses around medical and pharmacy expense, business analysis, documentation of business requirements, and defining current/future scope of work.
  • Create and manage clinical affordability projects with internal partners, including but not limited to pharmacy, other clinical and network affordability teams, and pilots. Create innovative solutions and process enhancements to drive financial and quality success.
  • Lead Clinical Model development and process support for the program in all approved state regions to align with the Clinical Model and meet the requirements for the program by supporting reports , technology and core team. Identify trends between Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Member Engagement.
  • Establish the organizations focus and direction regarding models of care that incorporate needs of all lines of business, focusing on quality and operational efficiencies across the organization. Create and measure business and clinical outcomes with respect to the provision of clinical support for practice transformation and successful transition of practice to shared savings/risk contract.
  • Qualifications - Medical Doctor or Master’s degree in Nursing, Therapy, Pharmacy, Public Health/Administration or related field. MBA preferred. 8+ years of clinical experience in the Healthcare industry. Broad understanding of HEDIS and how it is used to drive business growth and efficiencies.Unrestricted license as MD, DO, PA, PT, OT, ST, RpH or PN in NC. Must reside in North Carolina. More than 5 years of demonstrated care management/population health experience in a large healthcare corporation serving Medicaid beneficiaries.


Posted September 14, 2020

Covered

Not Covered