[Hiring] Clinical Quality Program Manager @Elevance Health

Role Description

The Clinical Quality Program Manager is responsible for serving as a liaison with and overseeing the quality improvement activities/projects/programs for one or more states within a major line of business.

This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

• Leads state level quality strategy meetings, develops a quality plan, and ensures integration of quality into the overall business process.
• Works with the clinical intervention team to design studies to identify barriers to medical interventions.
• Ensures that study methodology is sound and appropriate reporting is in place.
• Develops performance improvement plans and oversees the clinical quality improvement activities/projects to improve the quality of care for members.
• Assures compliance with corporate QI work plans.
• Assures that all QI activities are relevant to the needs of targeted population.
• Maintains effective documentation of research programs to meet regulatory and Accreditation Standards.
• Provides oversight to assure accurate and complete quantitative analysis of clinical data and presentation of data analysis results.
• Participates in and provides input to the development of new product designs for major line of business.
• Oversees the implementation of new initiatives.
• Leads interactions with regulators or oversight entities.
• Oversees quality improvement activities for the largest, most complex state programs.

Qualifications

• Requires a BS in health administration, nursing, or a related clinical field.
• 4 years of health care quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.

Requirements

• Physical Therapist or Occupational Therapist preferred.

Benefits

• Market-competitive total rewards including merit increases, paid holidays, and Paid Time Off.
• Incentive bonus programs (unless covered by a collective bargaining agreement).
• Medical, dental, vision, short and long term disability benefits.
• 401(k) + match, stock purchase plan, life insurance.
• Wellness programs and financial education resources.