Clinical Quality Program Manager

Elevance Health - Overland Park, KS

Full-time - Mid Level

Overland Park, KS

11-50 employees

Insurance Carriers and Related Activities

About the position

The Clinical Quality Program Manager at Elevance Health is responsible for overseeing quality improvement activities and projects for multiple states within a major line of business. This role involves leading quality strategy meetings, developing quality plans, and ensuring the integration of quality into business processes to enhance the quality of care for members.

Responsibilities

• Leads state level quality strategy meetings and develops a quality plan.
• Ensures integration of quality into the overall business process.
• Works with the clinical intervention team to design studies identifying barriers to medical interventions.
• Ensures sound study methodology and appropriate reporting.
• Develops performance improvement plans and oversees clinical quality improvement activities.
• Assures compliance with corporate QI work plans and relevance to targeted populations.
• Maintains effective documentation of research programs to meet regulatory and accreditation standards.
• Provides oversight for accurate quantitative analysis of clinical data and presentation of results.
• Participates in the development of new product designs for major lines of business.
• Oversees implementation of new initiatives and interactions with regulators or oversight entities.
• Manages project scope to ensure business needs are met and project scope is delivered.

Requirements

• BS in health administration, nursing, or a related clinical field.
• 4 years of health care quality or data analysis experience, or equivalent education and experience.

Nice-to-haves

• Current unrestricted license or certification in applicable field (i.e. CPHQ).
• MS in the health field (i.e. Nursing) is preferred.
• Experience with regulatory/accreditation audits/standards, HEDIS or CAHPS in a health or managed care environment.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical, dental, and vision benefits
• Short and long term disability benefits
• 401(k) with matching
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources