HealthCare Partners, New York

Director, Population Health Analytics (Garden City, NY)

HealthCare Partners, IPA and HealthCare Partners, MSO together comprise our health care delivery system providing enhanced quality care to our members, providers and health plan partners. Active since 1996, HealthCare Partners (HCP) is the largest physician-owned and led IPA in the Northeast, serving the five boroughs and Long Island. Our network includes over 6,000 primary care physicians and specialists delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid products. Our MSO employs 200+ skilled professionals dedicated to ensuring members have access to the highest quality of care while efficiently utilizing healthcare resources.

HCP’s vision is to be recognized by members, providers and payers as the organization that delivers unsurpassed excellence in healthcare to the people of New York and their communities.

We pride ourselves on selecting the most qualified candidates who reflect HCP’s mission of serving our members by facilitating the delivery of quality care.

Interested in joining our successful Garden City Team? We are currently seeking a Director of Population Health Analytics for our Garden City Office!

Essential Position Functions/Responsibilities:

Team Leadership and Operations:

• Lead and manage a team of analysts responsible for data collection, analysis, and regulatory reporting
• Oversee the daily operations of the team, ensuring efficiency processes and timely delivery of data-related functions
• Develop and provide expertise in risk adjustment and quality for various lines of business regarding the data utilized for measurement
• Provide guidance, coaching, and professional development opportunities to team members

Data Analysis and Reporting:

• Lead the design, development, and implementation of population health analytics strategies, methodologies, and tools
• Utilize advanced analytics techniques to extract meaningful insights from large and complex
• healthcare datasets
• Generate reports, dashboards, and visualizations to effectively communicate key findings to stakeholders.
• Conduct regular data analysis to monitor population health metrics, trends, and performance indicators.
• Determine, document, modify, and ensure compliance with policies and procedures involving database management, analysis, and publication
• Prepare timely and accurate monthly and annual reporting statements as required
• Monitor industry trends to identify areas of improvement

Population Health Strategy and Improvement:

• Collaborate with key stakeholders to define population health goals and objectives
• Identify gaps and opportunities for improving population health outcomes and care delivery processes
• Develop data-driven strategies and initiatives to address identified gaps and improve health outcomes
• Monitor the effectiveness of implemented initiatives and make recommendations for continuous improvement

Risk Adjustment, Risk Stratification and Predictive Modeling:

• Understand CMS risk score methodology including risk score calculation, key regulatory
• deadlines for data submission, understand eligibility, claims, and provider data
• Support the Risk Adjustment team in ensuring that key risk adjustment performance metrics
• and business objectives are defined and achieved
• Develop and implement risk stratification methodologies to identify high-risk patient populations.
• Utilize predictive modeling techniques to forecast healthcare utilization, cost, and risk scores
• Collaborate with clinical teams to prioritize interventions for high-risk populations and optimize care management programs.

Collaboration and Stakeholder Management:

• Collaborates with interdisciplinary teams, including business intelligence, care management, quality improvement, and provider relations, to develop dashboards that report key performance progress and support population health initiatives
• Collaborate with internal and external stakeholders to share insights, best practices, and
• recommendations.
• Provide guidance and education on population health analytics to enhance organizational
• understanding and capabilities.
• Develop, code, and prepare reports to support essential Quality, Risk Adjustment, and Population Health functions to measure and forecast risk scores & quality metrics

Qualification Requirements:

Skills, Knowledge, Abilities

• Strong proficiency in data analysis, statistical modeling, and visualization tools (e.g., SAS, SQL, Python, R, Tableau, etc.)
• Experience working with large healthcare datasets, including claims, clinical, and administrative data
• Knowledge of population health concepts, risk stratification methodologies, and predictive modeling techniques
• Familiarity with healthcare quality measures (e.g., HEDIS, STARS, QARR) and regulatory requirements
• Intermediate proficiency in MS Office Suite (primarily Excel)
• Strong organizational skills with the ability to prioritize and manage multiple projects simultaneously between cross-functional teams
• Strong technical abilities with advanced data and analytics tools and programming languages.
• Excellent problem-solving and critical skills with the ability to interpret complex data and provide actionable insights
• Demonstrated leadership abilities with experience managing a team and leading projects
• Strong verbal, written, and excellent communication and presentation skills to effectively communicate complex analytical concepts to both technical and non-technical stakeholders

Training/Education:

• Bachelor’s degree in a relevant field such as Health Informatics, Healthcare Administration, Computer Science, Data Science, Information Systems, Public Health, or a related discipline. Advanced degree preferred

Experience:

• Minimum of 5 years of experience in healthcare analytics, population health management, or a related field
• 4-7 years of experience in a healthcare setting
• 5+ years of managing complex data analysis and interpretation of HEDIS/QARR/STARS/RAF/HCC
• 3+ years of supervisory/managerial experience
• Knowledge of regulations related to Medicare Advantage, Medicaid, and Commercial plans
• Familiarity with NCQA, NYSDOH, CMS, and health plan relationships
• Familiarity with Risk Scoring Models

HealthCare Partners, MSO provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, HealthCare Partners, MSO complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

HealthCare Partners, New York