About this role
Location Address:
Remote Office Santa Fe, NM 87501
Compensation Pay Range:
Minimum Offer $108,680.00 Maximum Offer $190,694.40 Now 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 time Job Exempt: Yes Job is based: Remote Workers New Mexico Work Shift: Days (United States of America)
Responsibilities
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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.
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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:
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Government Programs Population Health Strategy
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Develop population health strategies for ACA, Medicaid, and D-SNP populations aligned with enterprise priorities
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Identify high-impact opportunities to improve outcomes for complex and vulnerable populations
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Ensure alignment with regulatory requirements and product-specific goals
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Clinical Initiative Portfolio Strategy & Prioritization
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Support development and refinement of the Clinical Initiative Portfolio
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Partner with product owners and leadership to prioritize initiatives based on impact and ROI
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Define success metrics aligned with HEDIS, Stars, risk adjustment, and utilization goals
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Clinical Program Design & Strategic Guidance
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Design evidence-based clinical programs and interventions
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Define target populations, program goals, and success measures
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Partner with program and operational leaders to support implementation and scaling
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Inform build vs. buy decisions for clinical capabilities
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Provider Strategy & Performance Enablement
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Translate clinical strategies into provider-facing approaches
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Support development of provider tools, workflows, and reporting
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Provide input into value-based care models and provider performance strategies
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Product & Cross-Functional Alignment
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Serve as liaison to Government Programs teams
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Ensure alignment between benefit design, clinical programs, and population health outcomes
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Collaborate with analytics, network, and operations teams
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Analytics & Insights
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Partner with analytics teams to define measurement frameworks
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Use data to identify trends, gaps, and opportunities
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Translate insights into actionable recommendations
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Regulatory & Compliance Strategy
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Ensure strategies align with CMS and Medicaid requirements
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Support audits, reporting, and program integrity efforts
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Health Equity & Community Integration
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Embed health equity into all strategies and program designs
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Identify disparities and recommend targeted interventions
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Partner with community organizations and internal teams
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Medicare Stars and HEDIS performance
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Medicaid quality measures
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Gap closure and preventive care utilization
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Total cost of care and utilization trends
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Clinical Initiative Portfolio performance and ROI
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Health equity outcome measures
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Reports to: Vice President, Population Health, Provider Strategy and Performance
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Key partnerships: Government Programs Product Owners, Provider Strategy, Analytics, Network Management, Compliance, Community Health
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Collaborates across Presbyterian Health Plan and Medical Group
Qualifications
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Bachelor’s degree required; Master’s degree (MPH, MHA, MBA, or related) preferred
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5–10+ years of experience in population health, healthcare strategy, or clinical program design
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Experience with Medicare (D-SNP) and/or Medicaid programs
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Strong understanding of HEDIS, Stars, risk adjustment, and utilization drivers
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Experience working in a matrixed organization
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Strategic thinking and portfolio prioritization
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Clinical program design and innovation
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Data-driven decision making
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Cross-functional collaboration and influence
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Strong communication and executive presence
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Health equity focus
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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.
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Wellness
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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.
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Why work at Presbyterian?
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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.
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About Presbyterian Healthcare Services
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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.
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Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
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AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.