AD, TP/PIHP/TO Population Health

Adult Correction; North Carolina; Hybrid; USD 76,000 - 148,000; Full time

Job summary

North Carolina Department of Health and Human Services (DHHS) seeks an Assistant Director for TP/PIHP/TO Population Health to lead design, development, and implementation of quality measurement, quality management, and analytics within NC Medicaid.

The role focuses on population health initiatives across Tailored Plans, PIHP, and Tribal Option, collaborating with state agencies, tribes, providers, and beneficiaries to drive improvements and innovation. Hybrid work is available.

Qualifications

• Experience implementing care management models and healthcare innovations.
• Experience managing health benefit programs and provider relationships.
• Experience applying health insurance program knowledge to oversight and performance monitoring.
• Proficient data analysis of complex datasets to identify trends and outcomes.
• Advanced MS Office (Word/Excel/PowerPoint) for reports and presentations.

Responsibilities

• Lead design, development, and implementation of quality measurement and quality management activities.
• Develop and implement performance improvement initiatives to strengthen program outcomes.
• Design processes and systems to support healthcare innovation within NC Medicaid.
• Monitor managed care and primary care programs to evaluate performance and compliance.
• Oversee population health initiatives including TP, PIHP, and TO options.
• Analyze performance data to identify trends and support strategic decisions.
• Collaborate with agencies and providers to implement population health initiatives.
• Engage with advocacy organizations and beneficiary representatives to inform planning.
• Coordinate with stakeholders to oversee contracted population health activities.
• Communicate findings and recommendations to leadership and partners.

Skills

Care management

Data analysis

Stakeholder engagement

Population health

Leadership

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

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.

This Position 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