Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
' Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
' Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
' Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
' Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
JOB SUMMARY
The Population Health Programs Manager is responsible for leading the design, implementation, and evaluation of population health programs and services that address the needs of defined populations and advance the organization's population health strategy. The role translates departmental strategic direction into program plans and governance, and ensures measurable performance against key health-related, equity, quality, utilization, and experience outcomes.
Work also involves directing day-to-day program operations and resources, including setting priorities, monitoring budgets and timelines, developing and maintaining policies and procedures, and overseeing vendor and partner deliverables as applicable. This position leads cross-functional coordination with various health services teams and other divisions within the organization as appropriate; sponsors the annual population health assessment; and translates findings into an actionable, enterprise-aligned program roadmap.
This position serves as the organization's population health subject matter expert and primary point of accountability for program outcomes and collaboration. The manager provides matrix leadership and consultative support to program staff and project teams by facilitating cross-functional alignment, removing barriers, and promoting adoption of best practices; builds and sustains relationships with internal leaders, providers, and community partners; and drives initiatives that improve outcomes and reduce health disparities for target populations through data-informed decision-making and continuous improvement.
JOB SPECIFICATIONS AND CORE COMPETENCIES
Lead the design, implementation, and ongoing management of evidence-based population health programs and interventions, leveraging internal resources and external partners to meet defined objectives.
Conduct and coordinate the annual population health assessment, synthesize findings with analytics and operational partners, and prioritize opportunities that inform the program strategy.
Provide matrix leadership to coordinate population health initiatives across internal departments and teams, aligning scope, timelines, roles, and deliverables. Establish and maintain the program operating model (workplans, meeting cadence, decision logs), policies/procedures, and accreditation/vendor/partner deliverables as applicable.
Develop and implement strategies to engage members, providers, and community partners and to support program adoption, participation, and adherence, including development of operational workflows and communication plans.
Define program success measures and monitor performance using population health, quality, utilization, and experience data; evaluate program effectiveness; identify gaps; and lead continuous improvement activities in partnership with analytics and operational teams.
Prepare and present routine and ad hoc status updates, performance summaries, and recommendations to leadership and governance forums.
Maintain awareness of applicable regulations, accreditation requirements, and emerging best practices in population health management; assess impact and recommend updates to programs, workflows, and measures.; Other duties as assigned
MINIMUM QUALIFICATIONS:
Education/Training/Certification: Bachelor's degree in public health, health administration, nursing, social work, epidemiology, or a related field required.
Master's degree in public health, health administration, business, or a related field preferred.
Certification or training in project management and/or quality improvement (e.g., CPHQ, PMP, Lean/Six Sigma) preferred.
Work Experience (Years and Area): 5+ years of experience in population health, care/disease management, community health, or health promotion, including leading cross-functional initiatives and using data to drive program performance
Experience in managed care (e.g., Medicaid/Medicare and/or value-based arrangements) and demonstrated success partnering with providers and community-based organizations.
Management Experience (Years and Area): Demonstrated matrix leadership (no direct reports required), including leading projects/workgroups, influencing stakeholders, and driving accountability for deliverables
Formal supervisory experience and/or budget/vendor management experience
Software Proficiencies: Proficient in Microsoft Office (Word, Excel, PowerPoint) and in reporting/visualization tools (Power BI or comparable). Working knowledge of care management/case management platforms and the ability to define reporting requirements, interpret dashboards, and translate data into operational actions.
Experience with SAS, SPSS, R, Python, SQL, or other analytic tools; familiarity with data quality concepts and basic research/statistical methods
Other: Strong analytical and problem-solving skills; ability to synthesize complex data into clear insights and actionable recommendations
Demonstrated program/project management skills (scope, workplans, timelines, risks/issues, dependencies)
Proven ability to influence without authority, facilitate cross-functional decision-making, and drive accountability for deliverables
Experience with program evaluation, performance monitoring, and continuous improvement methodologies
Knowledge of healthcare delivery systems, care management operations, social determinants of health, and community resources
Strong written, verbal, and presentation skills; ability to communicate effectively with leaders, providers, and community partners
Ability to manage competing priorities and deliver results in a fast-paced, highly collaborative environment
Experience developing policies/procedures, facilitating governance forums, or managing vendors/contracts
Experience with outcomes measurement and value-based initiatives
