Clinical Program and Population Health Strategist – Government Programs

Presbyterian Healthcare Services

Clinical Program and Population Health Strategist role at Presbyterian improving health outcomes for ACA, Medicaid, and D-SNP populations, collaborating across healthcare delivery systems.

Posted 7/18/2026full-timeSanta Fe • New Mexico • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in developing and implementing population health strategies for ACA, Medicaid, and D-SNP populations, with a strong focus on health equity and regulatory compliance. Proficient in clinical program design, data-driven decision making, and cross-functional collaboration to enhance health outcomes.

Highest-signal resume keywords

Population Health Strategy DevelopmentClinical Program DesignHEDIS and Stars MetricsCross-Functional CollaborationHealth Equity Focus

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Population Health StrategyClinical Program DesignData-Driven Decision MakingPortfolio PrioritizationRegulatory ComplianceMedicare and Medicaid ProgramsRisk AdjustmentUtilization ManagementHealth Equity StrategiesQuality Measure Analysis

Soft Skills

Strategic ThinkingStrong CommunicationExecutive PresenceCross-Functional InfluenceCollaboration

Certifications & Qualifications

Bachelor's DegreeMaster's Degree (MPH, MHA, MBA Preferred)

Industry Keywords

Government ProgramsClinical Initiative PortfolioValue-Based CareHealth Value StrategyCommunity IntegrationPreventive Care UtilizationTotal Cost of CareMedicaid Quality MeasuresGap ClosureProvider Performance

About the role

Key responsibilities & impact

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.
Clinical Initiative Portfolio Strategy & Prioritization 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.

Requirements

What you’ll need

Bachelor’s degree required; Master’s degree (MPH, MHA, MBA, or related) preferred
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.

Benefits

Comp & perks

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.