Population Health Manager - UW Medicine


CLOSING DATE: open until filled


JOB #: 12624

POSTED: May 24, 2018


UW Medicine’s mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow’s physicians, scientists and other health professionals.  UW Medicine owns or operates Harborview Medical Center, Northwest Hospital & Medical Center, Valley Medical Center, UW Medical Center, a network of UW Medicine Neighborhood Clinics that provide primary care, UW Physicians, UW School of Medicine, Airlift Northwest, and other owned, operated or affiliated entities as appropriate. In addition, UW Medicine shares in the ownership and governance of Children’s University Medical Group and Seattle Cancer Care Alliance a partnership among UW Medicine, Fred Hutchinson Cancer Research, and Seattle Children’s. 

UW Medicine Population Health Management is excited to be recruiting for newly-created, outstanding opportunities: Population Health Managers. These grant-funded positions will be full-time, 100% FTE and anticipated to be 12-14 months in duration with possible extension based on funding.  The Population Health Manager (PM) is a newly-created and unique care manager position within the UW Medicine Population Health Management team.  The role is a clinical position created to support UW Medicine’s Care Management Program with particular focus on Transitional Care Management (TCM), Chronic Care Management (CCM), and High Risk Care Management (HRCM). The Population Health Manager will serve as a central Population Health Management liaison providing support to our primary care clinics as UW Medicine seeks to optimize TCM and CCM opportunities for our entire patient population that experience an inpatient admission post discharge. This role will also support our primary care nurse care managers in their HRCM work.  The primary responsibility of the Population Health Manager will be to coordinate post-inpatient discharge visit follow-up with a primary care provider (PCP).  

The Population Health Manager will contact targeted patients within a specified time-period and during the interactive contact address health literacy in regards to discharge instructions, targeted open care gaps, and identify CCM needs.  The Population Health Manager will directly interface with providers, health care teams, and patients onsite in the primary clinic setting. The position acts under the overall strategic direction of the Administrator of Population Health Management and reports day-to-day to the Director of Patient Outreach and Care Management.  The Population Health Manager will be involved in implementing system-level structural optimization processes and procedures and implementing at a local level in the primary care clinic setting.  

  • Transitional Care Management (TCM), Chronic Care Management (CCM), and High Risk Care Management (HRCM), including analytics 

  • Relationship Management to Optimize Care Management 

  • Quality & Compliance 

  • Other responsibilities to support the overall goals of the population gap management initiative




  • Bachelor’s degree in Nursing, or graduate degree from an accredited Nurse Practitioner or accredited Physician Assistant program. 
  • Current and valid license as Registered Nurse (RN), Advanced Registered Nurse Practitioner (ARNP), or Physician’s Assistant (PA) in the State of Washington. 
  • Four to five years of relevant clinical nursing experience, preferably in an ambulatory care setting, care management, case management, or clinical coordination.  
  • Skill set to telephonically assess a patient’s health literacy and self-management of care. 
  • Skill set to effectively answer patients questions via phone and give appropriate guidance. 
  • Skill set to support care gap closure that can be done via the phone, which may include gathering information from patient that directs to where prior preventative screenings furnished so  records can be requested 
  • Skill set to provide care management or to quickly learn that process. 
  • Skills to assess clinically patients needing additional support through chronic care management. 
  • Demonstrated ability to sort through data reports to identify targeted patients. 
  • Demonstrated flexibility in being deployed at one primary care clinic while serving several clinics; as well as receiving some supervision by primary care clinic leadership while being managed by central Population Health Management director. 
  • Demonstrated ability to work collaboratively primary care medical home team, as well as the population health care management team. 
  • Organized, goal-oriented, and determined to meet time targets or deadlines.  
  • Track record of being confident to speak up when any issues arise or problems have been identified. 
  • Comfortable learning new computer software programs. 
  • Demonstrated ability to efficiency facilitate the scheduling of provider appointments. 
  • Track record of appropriate telephone etiquette. 
  • Diligent with timely and clear documentation of activities. 
  • Enjoys and embraces challenges and achieving targeted goals. 
  • May need to use the provided language line when speaking with Non-English patients. 
  • An equivalent combination of education and experience may substitute for stated requirements.  

Excellent benefits and opportunity to work with a fast-paced, challenging, diverse and rewarding environment!  To learn more, visit http://bit.ly/2JDI0Xt



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