Clinical Quality Program Administrator

2 days ago

Olathe, Kansas, United States Elevance Health Full time
Job Summary

We are seeking a highly skilled Clinical Quality Program Administrator to join our team at Elevance Health. This is a hybrid position requiring 1-2 days per week in the office, and you must be within 50 miles of Topeka or Overland Park/Olathe.

Key Responsibilities
  • Oversee quality improvement activities/projects as outlined in the Quality Improvement (QI) work plan and as required by applicable law, regulations, and accreditation standards.
  • Ensure integration of quality into the overall business process.
  • Perform assessments to identify gaps in the enterprise's quality and technology assessment processes and initiate actions to correct these gaps.
  • Assure accuracy and completeness of input provided to internal and external QI committees and timely implementation of appropriate interventions.
  • Oversee clinical quality improvement activities/projects to implement appropriate clinical interventions to improve the quality of care for members.
  • Assure compliance with corporate QI work plans.
  • Assure QI activities are relevant to the targeted population.
  • Assure compliance to Practice Guideline, Delegation, and Continuity and Coordination of care Standards.
  • Maintain documentation of research programs to meet regulatory and Accreditation Standards.
  • Provide oversight to assure accurate and complete quantitative analysis of clinical data and presentation of results.
  • May provide oversight to the Healthcare Effectiveness Data and Information Set (HEDIS) project team.
Requirements
  • Requires a BS in health administration, nursing, or related clinical field; 3 years of healthcare quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.
  • Current unrestricted license or certification in applicable field preferred (i.e. CPHQ).
  • Prior HEDIS experience is very strongly preferred.
  • You must be proficient in Microsoft Office applications, especially Excel.
  • Strong organizational and data analysis skills are needed for this role.
About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and 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, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.

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