We are looking for a dedicated Registered Nurse to join our team as a Director of Population Health to service our patients in the Aiken, SC area. The Director of Population Health is a clinical and strategic leader responsible for driving Your Health's population health initiatives across regions, while also directly managing high-risk patient populations. This role blends data-informed decision-making, clinical case management, and
leadership to improve care quality, reduce unnecessary utilization, and ensure effective transitions of
care for complex patient cohorts.
The Director is accountable for identifying gaps in care, overseeing risk stratification efforts, engaging with high-risk patients, and ensuring effective care coordination workflows are executed from a patient-first, value-based perspective.
This position will be working daily in our Aiken, SC office. This is a full-time, salary-based 8-hr position 8:00AM-5:00PM) (Monday-Friday).
What Are We Looking For?A successful Director of Population Health will be able to perform these essential duties and
responsibilities. Reasonable accommodations may be made, in accordance with applicable law, to
enable individuals with disabilities to perform the essential functions.
The following is a list of essential functions, which may be subject to change at any time and without
notice. Management may assign new duties, reassign existing duties, and/or eliminate function(s).
Areas of Responsibility:- Develop and implement strategies to identify and manage at-risk patient populations using clinical judgment and data analytics.
- Partner with executive leadership and analytics teams to improve outcomes tied to value-based contracts and payer performance goals.
- Monitor trends in chronic disease burden, hospitalizations, ED use, readmissions, and patient engagement to inform targeted interventions.
- Serve as the clinical lead for regional population health efforts and drive consistency across teams.
- Personally manage outreach and coordination for high-risk patients, including those with complex medical, behavioral, or social needs.
- Support transitions of care following hospital discharge, SNF stays, or acute events-ensuring timely follow-up and appropriate plan of care execution.
- Coach and mentor other clinical staff on documentation, coordination standards, and value-based care concepts.
- Participate in organizational training sessions and support onboarding of new staff where population health strategy intersects with direct care.
Qualifications - Registered Nurse (RN) license required; BSN preferred. License must be in good standing.
- Minimum 3 years of clinical experience, ideally in a home-based, community health, or care management setting.
- Demonstrated experience managing high-risk or complex patient populations.
- Familiarity with value-based care models, risk stratification, and patient engagement strategies.
- Must be proficient in utilizing technology tools and platforms for remote patient monitoring, telemedicine, and electronic medical records.
- Ability to read and communicate effectively.
- Strong written and verbal skills.
- Basic computer knowledge.
- Ability to manage and demonstrate effective leadership skills.
- Should demonstrate good interpersonal and communication skills under all conditions and circumstances.
- Ability to foster a cooperative work environment.
- Team player with ability to manage multiple responsibilities and demonstrate sound judgment.
- Must be able to work flexible hours and travel between offices, facilities, etc. Must be a licensed driver with an automobile that is insured in accordance with state and/or organizational requirements and is in good working order
