AD, TP/PIHP/TO Population Health

State of North Carolina; North Carolina; Hybrid; USD 76,000 - 148,000; Full time

Job summary

The State of North Carolina’s Department of Health and Human Services seeks an Assistant Director for TP/PIHP/TO Population Health to lead quality measurement, performance improvement and analytics within NC Medicaid. You will design and implement initiatives across Tailored Plans, PIHP and Tribal Option, collaborating with DHHS agencies, tribal representatives, providers and advocates.

The role reports to the Deputy Director of Population Health and focuses on strategy, monitoring, and

Qualifications

• Master's degree in an area specific to the program and five years of experience, including three in supervisory or consultative capacity.
• Bachelor's degree in an area specific to the program and seven years of experience, including three in supervisory or consultative capacity.
• Equivalent combination of education and experience.

Responsibilities

• Lead the design, development, and implementation of quality measurement and management activities.
• Monitor managed care and primary care programs for performance and compliance.
• Collaborate with DHHS agencies and stakeholders to support population health initiatives.
• Communicate findings and recommendations to leadership for continuous improvement.
• Oversee population health initiatives related to TP, PIHP, and TO.

Skills

Care management models

Data analysis

Provider relationships

Stakeholder engagement

MS Office

Education

Master's degree in related field

Bachelor's degree in related field

Tools

Microsoft Word

Excel

PowerPoint

Job description

Agency

Dept of Health and Human Services

Division

HEALTH BENEFITS

Job Classification Title

Human Services Program Manager III (NS)

Position Number

60042836

Grade

NC22

About Us

The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.

Description of Work

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.

Knowledge Skills and Abilities/Management Preferences

_ Salary Grade Range: $75,925.00 - $148,054.00 _

_ Recruitment Range: $75,925.00 - $102,112.00 _

Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement.

The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred:

• Demonstrated experience implementing care management models, clinical program innovations, system redesign initiatives, or healthcare workforce development strategies that supported measurable improvements in program operations and service delivery.
• Proven success managing health benefit programs, provider relationships, and healthcare service operations within a healthcare or human services environment while supporting program goals and stakeholder engagement.
• Documented experience applying health insurance program knowledge, operational procedures, and provider contracting processes to support oversight, program implementation, and performance monitoring activities.
• Demonstrated proficiency analyzing complex data sets, performance measures, and program information to identify trends, evaluate outcomes, and communicate probable impacts to leadership and stakeholders.
• Advanced proficiency using Microsoft Word, Excel, and PowerPoint to develop reports, analyze data, present findings, and support quality improvement and population health initiatives.

The Posting Will Close At 11:59 P.M. The Night Before The End Date

This Position Is Funded In Part Through Federal Funds

This Position Is Eligible For A Hybrid Work Option

EHRA: Per G.S. 126-5(c1) (37), This Position Is EXEMPT From All Provisions Of NC General Statute Chapter 126 (State Human Resources Act) With The Exception Of Articles 6 And 7.

About the NC Division of Health Benefits:

The Division of Health Benefits (DHB)within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $27 billion in state and federal funds per fiscal year, DHB ensures that more than 108,000 enrolled providers are reimbursed for delivering covered services to 3.1 million beneficiaries.

Compensation and Benefits:

The State of North Carolina offers excellent comprehensive benefits. Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis). Employees also receive paid vacation, sick, and community service leave. In addition, paid parental leave is available to eligible employees.

Visit the website for State Benefits.

Supplemental Contact Information:

The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employerthat embraces an Employment First philosophy, which consists of complying with all federallaws, state laws, and Executive Orders. We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job. For more information about DHHS: https://www.ncdhhs.gov/.

DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position.

In accordance with the Governor's Executive Order 303, our agency supports second-chance employment for individuals who were previously incarcerated or justice-involved. We invite all potential applicants to apply for positions for which they may be qualified.

Degree/College Credit Verification

Degrees must be received from appropriately accredited institutions. Transcripts, degree evaluations, and cover letters may be uploaded with your application.

Veterans' and National Guard Preference

• Applicants seeking Veteran's Preference must attach aDD-214 Member-4 Form(Certificate of Release or Discharge from Active Duty) to their applications.
• Applicants seeking National Guard Preference must attach an NGB 23A (RPAS), along with the state application, if they are a current member of the NC National Guard in good standing.
• Applicants who are former members of either the NC Army National Guard or the NC Air National Guard, with honorable discharge and six years of creditable service, must attach a copy of the DD 256 or NGB 22, along with the state application.

ADA Accommodations

Consistent with the Americans with Disabilities Act (ADA) and the Pregnant Workers Fairness Act (PWFA), DHHS is committed to the full inclusion of all qualified individuals. As part of this commitment, DHHS will ensure that people with disabilities, or known limitations covered by the PWFA, are provided with reasonable accommodation. If reasonable accommodation is needed to participate in the job application or interview process, please contact the person indicated below.

_CONTACT INFORMATION_

If there are any questions about this posting, please contact Talent Acquisition at [e-mail]. Resumes will not be accepted in lieu of completing this application.

Minimum Education and Experience

Some state job postings say you can qualify by an "equivalent combination of education and experience." If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See the Education and Experience Equivalency Guide for details.

Master's degree in an area specific to the program from an appropriately accredited institution and five years of experience in the area of assignment, including three years in a supervisory or consultative capacity

OR

Bachelor's degree in an area specific to the program from an appropriately accredited institution and seven years of experience in the area of assignment, including three years in a supervisory or consultative capacity

OR

An equivalent combination of education and experience.

EEO Statement

The State of North Carolina is an Equal Employment Opportunity Employer and dedicated to providing employees with a work environment free from all forms of unlawful employment discrimination, harassment, or retaliation. The state provides reasonable accommodation to employees and applicants with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for religious beliefs, observances, and practices.

Recruiter:

Tresha Walker

Contact:

DHHS Workday Support Form