Clinical Program and Population Health Strategist-Government Programs

About the role

Build your Career. Make a Difference. Presbyterian is hiring a skilled Clinical Program and Population Health Strategist-Government Programs to join our team. Type of Opportunity: Full time Job Exempt: Yes Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Weekday Schedule Monday-Friday (United States of America)

Responsibilities

• Some key responsibilities include:
• Government Programs Population Health Strategy
• Develop population health strategies for ACA, Medicaid, and D-SNP populations aligned with enterprise priorities
• Identify high-impact opportunities to improve outcomes for complex and vulnerable populations
• Ensure alignment with regulatory requirements and product-specific goals
• Clinical Initiative Portfolio Strategy & Prioritization
• Support development and refinement of the Clinical Initiative Portfolio
• Partner with product owners and leadership to prioritize initiatives based on impact and ROI
• Define success metrics aligned with HEDIS, Stars, risk adjustment, and utilization goals
• Clinical Program Design & Strategic Guidance
• Design evidence-based clinical programs and interventions
• Define target populations, program goals, and success measures
• Partner with program and operational leaders to support implementation and scaling
• Inform build vs. buy decisions for clinical capabilities
• Provider Strategy & Performance Enablement
• Translate clinical strategies into provider-facing approaches
• Support development of provider tools, workflows, and reporting
• Provide input into value-based care models and provider performance strategies
• Product & Cross-Functional Alignment
• Serve as liaison to Government Programs teams
• Ensure alignment between benefit design, clinical programs, and population health outcomes
• Collaborate with analytics, network, and operations teams
• Analytics & Insights
• Partner with analytics teams to define measurement frameworks
• Use data to identify trends, gaps, and opportunities
• Translate insights into actionable recommendations
• Regulatory & Compliance Strategy
• Ensure strategies align with CMS and Medicaid requirements
• Support audits, reporting, and program integrity efforts
• Health Equity & Community Integration
• Embed health equity into all strategies and program designs
• Identify disparities and recommend targeted interventions
• Partner with community organizations and internal teams
• Medicare Stars and HEDIS performance
• Medicaid quality measures
• Gap closure and preventive care utilization
• Total cost of care and utilization trends
• Clinical Initiative Portfolio performance and ROI
• Health equity outcome measures
• Reports to: Vice President, Population Health, Provider Strategy and Performance
• Key partnerships: Government Programs Product Owners, Provider Strategy, Analytics, Network Management, Compliance, Community Health
• Collaborates across Presbyterian Health Plan and Medical Group

Requirements

• Bachelor's degree required; Master's degree (MPH, MHA, MBA, or related) preferred
• 5-10+ years of experience in population health, healthcare strategy, or clinical program design
• Experience with Medicare (D-SNP) and/or Medicaid programs
• Strong understanding of HEDIS, Stars, risk adjustment, and utilization drivers
• Experience working in a matrixed organization
• Strategic thinking and portfolio prioritization
• Clinical program design and innovation
• Data-driven decision making
• Cross-functional collaboration and influence
• Strong communication and executive presence
• Health equity focus
• All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
• Wellness
• Why work a

Benefits

Additional Information

Location Address: 9521 San Mateo NE Albuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $103,500.80 Maximum Offer $162,073.60 Now Hiring: Clinical Program and Population Health Strategist-Government Programs

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