We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

Responsible for leading and directing a team of nurses and health coaches that provide Population Health (PH) and Condition (Disease) Management (DM) services and interventions for beneficiaries under the direction of the Director of Population Health. The Manager will lead and guide clinicians in providing integrated whole health services that improve health outcomes and healthcare experiences. In collaboration with the Director of Population Health, works to develop and implement clinical program components to optimize Population Health strategies, goals, policies and procedures to ensure compliance with contract and accreditation standards.

Education & Experience

Required:

• Bachelor's degree in Nursing, Health Administration, health-related field or Licensed Clinical Social Worker (LCSW)
• Current, unrestricted license or certification to independently work within scope of practice for the discipline within state of residence
• Minimum of five years' clinical experience with progressively responsible management experience in PH, DM, or CM operations and program development to include supervision of staff
• Experience in reviewing and evaluating data to assess program processes, metrics and outcomes

Preferred:

• Master's Degree in Nursing or related healthcare field
• Multi-state licensure
• Direct experience in Population Health or wellness programs
• Experience in developing training, policies, procedures and outcome driven activities

Key Responsibilities

• Direct operational leadership of PH and DM functions and staff to ensure compliance with contract requirements and adherence to contract deliverables.
• Plans, organizes and implements collection of data and preparation of reports that support PH and DM management activities.
• Systematically evaluates the quality and effectiveness of staff performance, analyzing appropriate data and information to identify areas of improvement; advises and coaches when appropriate and completes annual performance appraisals.
• Participates in the development of measurable outcomes, ensures measures are in place to monitor the impact of programs and services on the health status of beneficiaries being managed.
• Supervises staff to include interviewing and hiring; planning and implementing orientation and training strategies for new-hire employees; setting and managing expectations, coaching and ensuring team and individual goals are met.
• Develops and maintains expertise in contract and accreditation requirements as they pertain to disease management functions.

• Ensures adherence to accreditation standards, TRICARE policy, contractual requirements, and nationally recognized practice standards.
• Participates in development and annual review of desk procedures, education, and auditing to support uniform application of programs and compliance with program policy and standards.
• Participates in interdepartmental committees and/or workgroups that are pertinent to areas of responsibility.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Competencies

Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback.

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Delegation Skills: Provide clear performance expectations for projects and ensure adequate access to resources for completion.

High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Leadership: Successfully manage different styles of employees; provide clear direction and effective coaching.

Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; have a realistic understanding of relevant issues.

Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.

Technical Skills: Knowledge of TRICARE programs and benefits; managed care and health care administration concepts and principles; HIPAA; HEDIS and accreditation processes and the application of clinical criteria; working knowledge of managed care and chronic care program strategies and interventions; legal, regulatory requirements, and HIPAA privacy regulations; collaboration skills. Proficient with the Microsoft Office suite of applications.

Working Conditions

Working Conditions:

• Remote/virtual environment if preferred
• Availability to cover any work shift
• Ability to travel as needed
• Extensive computer work with long periods of sitting
• Department of Defense security clearance required

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $108, 000 to $120, 000 per year.

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from all backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.