Minimum Offer $108,680.00Maximum Offer $190,694.40Now Hiring: Remote Clinical Program and Population Health Strategist-Government Programs Summary:
Build your Career. Make a Difference. Presbyterian is hiring a skilled Clinical Program and Population Health Strategist-Government Programs to join our team.Type of Opportunity: Full timeJob Exempt: YesJob is based: Remote Workers New MexicoWork Shift: Days (United States of America) Responsibilities:
The Clinical Program & Population Health Strategist – Government Programs is responsible for advancing population health strategy for ACA, Medicaid, and Dual Eligible Special Needs Plan (D-SNP) populations. This role aligns with Presbyterian’s integrated delivery system (IDS) model and Health Value strategy, partnering across the health plan, medical group, and care delivery system.
The Strategist translates enterprise population health priorities into product-specific strategies, clinical program designs, and a prioritized Clinical Initiative Portfolio. This role influences execution through cross-functional partnerships but does not directly manage program operations or vendor performance.
Some key responsibilities include:
Government Programs Population Health Strategy
Develop population health strategies for ACA, Medicaid, and D-SNP populations aligned with enterprise priorities
Identify high-impact opportunities to improve outcomes for complex and vulnerable populations
Ensure alignment with regulatory requirements and product-specific goals
Support development and refinement of the Clinical Initiative Portfolio
Partner with product owners and leadership to prioritize initiatives based on impact and ROI
Define success metrics aligned with HEDIS, Stars, risk adjustment, and utilization goals
Clinical Program Design & Strategic Guidance
Design evidence-based clinical programs and interventions Define target populations, program goals, and success measures Partner with program and operational leaders to support implementation and scaling Inform build vs. buy decisions for clinical capabilities
Provider Strategy & Performance Enablement
Translate clinical strategies into provider-facing approaches
Support development of provider tools, workflows, and reporting
Provide input into value-based care models and provider performance strategies
Product & Cross-Functional Alignment
Serve as liaison to Government Programs teams
Ensure alignment between benefit design, clinical programs, and population health outcomes
Collaborate with analytics, network, and operations teams
Analytics & Insights
Partner with analytics teams to define measurement frameworks
Use data to identify trends, gaps, and opportunities
Translate insights into actionable recommendations
Regulatory & Compliance Strategy
Ensure strategies align with CMS and Medicaid requirements
Support audits, reporting, and program integrity efforts
Health Equity & Community Integration
Embed health equity into all strategies and program designs
Identify disparities and recommend targeted interventions
Partner with community organizations and internal teams
Medicare Stars and HEDIS performance
Medicaid quality measures
Gap closure and preventive care utilization
Total cost of care and utilization trends
Clinical Initiative Portfolio performance and ROI
Health equity outcome measures
Reports to: Vice President, Population Health, Provider Strategy and Performance
Key partnerships: Government Programs Product Owners, Provider Strategy, Analytics, Network Management, Compliance, Community Health
Collaborates across Presbyterian Health Plan and Medical Group
5–10+ years of experience in population health, healthcare strategy, or clinical program design
Experience with Medicare (D-SNP) and/or Medicaid programs
Strong understanding of HEDIS, Stars, risk adjustment, and utilization drivers
Experience working in a matrixed organization
Strategic thinking and portfolio prioritization
Clinical program design and innovation
Data-driven decision making
Cross-functional collaboration and influence
Strong communication and executive presence
Health equity focus
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services Originally posted on Himalayas
