Responsibilities:

The Population Health Specialist works collaboratively across Jefferson Health to keep people healthy, improve their overall experience of care and do so in the most efficient, effective way. The Population Health Specialist uses public health and/or healthcare delivery expertise to identify, design and deploy better ways to manage population health, evaluate effectiveness of initiatives, programs and designs across the system/s and improve approach to deliver on mission, vision and results.

Essential Functions:

• Develops tools, techniques, and talking points that will aid in promoting coordinated care for patients and populations
• Works independently, collectively, and/or collaboratively to ensure people/patients are connected to the services and resources that will keep them healthy
• Follows up with all patients that have recently used Hospital, Skilled Care, and Emergency Room services to ensure they are getting the follow up care prescribed and to help patients avert any other potential health issues that might arise
• Performs outreach to patients and customers that have not taken advantage of the proven preventative care health screenings. This is designed to find health issues while they can still be addressed and resolved-rather than waiting for a time when costly disease treatments are needed.
• Collects population health data for analysis and reporting to direct and support practice redesign initiatives and programs
• Collaborates closely with primary care offices throughout Jefferson to apply the PCMH model, in order to improve care coordination, in accordance with appropriate quality improvement (Lean, Change Agent, etc.) methodologies
• Develops action plans, implement, and evaluate Jefferson’s management of population health outcomes
• Assesses current state of hospital, primary care offices, etc., identify areas of improvement needed to achieve the PCMH model, and create an action plan for improvement
• Implements action plan for improvement within hospitals or offices, providing adequate support and education for the staff and patients
• Participates in population health, quality improvement, and health system innovation strategies and programs
• Interacts with co-workers, visitors, and other staff consistent with the iSCORE values of Jefferson.

Education:

Master’s Degree of Population Health (MPH)

Experience Requirements:

• Knowledge of age-specific developmental issues and aware of resources to assist patients, practices and populations.
• Knowledge of insurance, managed care regulations and/or primary care a plus.
• Ability to engage and communicate with patients/families, physicians and other healthcare professionals in a professional manner.
• Ability to maintain confidentiality of patient information, be a patient advocate, be collaborative and know how to delegate when appropriate. Computer proficiency required.

Covid Vaccination is a requirement for employment at Jefferson for employees working at Jefferson’s clinical entities or at the University. If you are not currently vaccinated you will be required to receive the vaccination prior to hire date if you are offered employment, unless you request and receive an approved medical or religious exemption from Jefferson.

Jefferson includes Thomas Jefferson University and Jefferson Health, a dynamic university and health system with broad reach across the Delaware Valley. Jefferson is the second largest employer in Philadelphia and the largest health system in Philadelphia based on total licensed beds.

Through the merger of Thomas Jefferson University and Philadelphia University in 2017, our University includes ten colleges and four schools. We are an NCAA Division II university and an R2 national doctoral university offering undergraduate and graduate-level programs that provide students with a forward-thinking education in architecture, business, design, engineering, fashion and textiles, health, medicine and social science.

Jefferson Health, the clinical arm of Thomas Jefferson University, has grown from a three-hospital academic health center in 2015, to an 18-hospital health system through mergers and combinations that include hospitals at Abington Health, Aria Health, Kennedy Health, Magee Rehabilitation and Einstein Healthcare Network. We have over 50 outpatient and urgent care centers; ten Magnet®-designated hospitals (recognized by the ANCC for nursing excellence); the NCI-designated Sidney Kimmel Cancer Center (one of only 70 in the country and one of only two in the region); and one of the largest faculty-based telehealth networks in the country. In 2021, Jefferson Health became the sole owner of HealthPartners Plan, a not-for-profit health maintenance organization in Southeastern Pennsylvania. We are the first health system regionally to create an aligned payer-provider partnership.

Jefferson’s mission, vision and values create an organization that attracts the best and the brightest students, faculty, staff, and healthcare professionals, as well as the most visionary leaders to drive exceptional results.

• OUR MISSION: We improve lives.
• OUR VISION: Reimagining health, education and discovery to create unparalleled value
• OUR VALUES: Put People First, Be Bold & Think Differently and Do the Right Thing

As an employer, Jefferson maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.