Manager Population Health

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.

Please note that all Martin's Point Health Care employees must be fully vaccinated against COVID-19 as a condition of employment.

Position Summary

The Manager position is responsible for the day-to-day operations of the Population Health Nurses as they work as members of the care team, assisting patients and families while collaborating with internal and external departments and agencies to manage and improve the health outcomes of a population, reduce costs, and enhance the experience of care. The Manger is responsible for managing both Population Health Nurse I and II roles. Approximately 15-20% of work will be in a case load performing PHN duties to cover for vacations/sick time/leave of absence, the remaining 80-85% will be in management and leadership responsibilities.




The Manager works closely with all members of the Clinical Integration Team as well as Health Plan Operations, Delivery System staff, and Support staff, including the Health Management Department, Member Services, Informatics, Marketing, Coding and Billing, Health Information Management, and Martins Point Management System. The Manager will ensure that processes and staff comply with applicable regulatory and accrediting body standards (i.e. American Nurses Association (ANA), Case Management Society of America (CMSA), and the National Committee for Quality Assurance (NCQA).

Job Description

Key Outcomes:

• Manages the day-to-day Population Health operations, including but not limited to the standard work in practice setting, clinical auditing, embedded care management, population assessment and stratification. Supervisor regularly monitors program evaluation metrics and measurements to ensure that targeted interventions remain relevant and appropriate
• Ensures that clinical care management programs are aligned with current industry evidence-based practice as well as local, national and regulatory compliance standards.
• Initiates, defines and provides ongoing monitoring relative to PHN Standard Work in practice locations.
• Initiates, defines and analyzes target populations for programs. Performs ongoing measurement of outcomes, modifies programs to continue to improve performance.
• Monitors staff productivity and performance metrics and outcomes to ensure productive and efficient team that meets all service and timeline standards.
• Conducts annual reviews and ensuring effective staff development. Promotes Population Health staff engagement in organizational and strategic plans, goals and projects.
• Participates in technology and system planning and enhancement; recommends and tracks technology modifications that support population health initiatives.

• Manages Population Health team employees consistent with HR policies and procedures to ensure standards and quality management. Ensures staff have all required resources necessary to effectively perform assigned duties.
• Works with patient panel in order to maintain clinical expertise and proximity to operations.
• Fulfills role of Population Health Nurse in part-time clinical capacity, including, but limited to:
  • Collaborates with providers, care teams, patients and their families, community resources, and data sources to maximize patient and population health, patient experience, and managing medical expense
  • Applies evidence based criteria, e.g. Centers for Medicare Services, Case Management Society of America, Global Initiative for Chronic Obstructive Lung Disease, American Diabetes Association, American Heart Association, and Healthcare Effectiveness Data and Information Set results in clinical decision making and care management processes and interventions
• Serves as clinical department representative in committees, focus groups and other strategic interdepartmental initiatives.
• Collaborates with other department supervisors, managers and team members to achieve departmental and organizational goals, including the medical directors.
• Identifies opportunities for process improvement and initiates or delegates projects.
• Ensures compliance with and integrity of all departmental processes and policies with contractual, regulatory and accreditation requirements
• Provides expertise in psycho social care models including palliative care and hospice to team and patients

Education/Experience:

• Licensed as an RN in Maine and other appropriate jurisdictions as necessary
• BS Degree in Nursing preferred
• 5 years of nursing experience in Population Health Management, and/or experience in Case Management, Disease Management and Utilization Management.
• Demonstrated leadership/management experience
• CCM required within one year of hire
• Minimum 3 years of leadership and/or management experience required

Skills/Knowledge/Competencies (Behaviors):

• Demonstrated ability to manage, organize and prioritize work load in a timely accurate manner.
• Demonstrated ability to develop and manage matrix teams to effective results.
• Knowledge of industry standards and innovative approaches to Population Health Management for ensuring high quality collaborative care, effective medical costs and service
• Demonstrated knowledge and experience using care management clinical systems and phone system technology.
• Demonstrated analytical knowledge and ability to assess performance against metrics.
• Demonstrated interpersonal, communications, operational, team building, and quality improvement skills.
• Excellent interpersonal, verbal and written communication skills
• Critical thinking: can identify root causes and implement creative solutions
• Ability to prioritize and manage multiple competing demands and to function independently
• Computer proficiency in Microsoft Office products including Word, Excel, and Outlook
• Strong management and leadership skills
• Demonstrates an understanding of and alignment with Martin’s Point Values.

There are additional competencies linked to individual contributor, provider and leadership roles. Please consult with your leader to discuss additional competencies that are relevant to your position.

We are an equal opportunity/affirmative action employer.

Do you have a question about careers at Martin’s Point Health Care? Contact us at: jobinquiries@martinspoint.org