AD, TP/PIHP/TO Population Health

Dept of Health and Human Services

HEALTH BENEFITS

Human Services Program Manager III (NS)

60042836

NC22

The Assistant Director for TP/PIHP/TO Population Health provides leadership for the design, development, and implementation of quality measurement, quality management, performance improvement, analytics, and healthcare innovation initiatives within NC Medicaid.

The position supports monitoring and oversight activities in managed care and primary care case management environments, with a specific focus on population health initiatives associated with Tailored Plans (TP), Prepaid Inpatient Health Plans (PIHP), and the Eastern Band of Cherokee Indians Tribal Option (TO).

The AD, TP/PIHP/TO Population Health role develops processes and systems that support both ongoing and emerging healthcare innovation efforts and collaborates extensively with DHHS agencies, DHB staff, Tribal Option representatives, advocacy organizations, Medicaid beneficiaries, and healthcare providers. The position reports to the Deputy Director of Population Health and contributes to the advancement of population health strategies across NC Medicaid programs.



Key Duties Include:
– Lead the design, development, and implementation of quality measurement and quality management activities that support NC Medicaid population health objectives.

– Develop and implement performance improvement initiatives that strengthen program outcomes and support healthcare innovation efforts.

– Design processes and systems that support ongoing and emerging healthcare innovation initiatives within NC Medicaid programs.

– Monitor managed care and primary care case management programs to evaluate performance, quality outcomes, and compliance with population health goals.

– Oversee population health initiatives associated with Tailored Plans (TP), Prepaid Inpatient Health Plans (PIHP), and the Eastern Band of Cherokee Indians Tribal Option (TO).

– Analyze performance and program data to identify trends, measure outcomes, and support strategic decision‑making.

– Collaborate with DHHS agencies, DHB staff, Tribal Option representatives, and healthcare providers to support implementation of population health initiatives.

– Engage with state and national advocacy organizations and Medicaid beneficiary representatives to inform program planning and improvement efforts.

– Support oversight of contracted population health activities by coordinating with internal and external stakeholders to ensure program effectiveness.

– Communicate program findings, trends, and recommendations to leadership and partners to support continuous quality improvement and healthcare innovation.

Tresha Walker