Clinical Quality Management Director
1 month ago
Location:
This position will work a hybrid model (remote and office). Must live within 50 miles/1 hour commute of an Elevance Health location.
The Clinical Quality Management Director is responsible for overseeing the day-to-day operations of accreditation and quality infrastructure work performed to meet regulatory requirements and client needs.
Key Responsibilities:
- Directs the development of a national quality plan and integrates quality into the overall business process.
- Evaluates industry best practices, medical research, and other resources to develop clinical programs and tools that facilitate and support quality, cost-effective care.
- Develops and implements an annual plan detailing strategies, programs, and tools to be implemented.
- Assures compliance with corporate QI work plans.
- Assures that all QI activities are relevant to the needs of the targeted population.
- Maintains 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 results of data analysis.
- Tracks program performance and results.
- Works with both internal and external customers to promote understanding of health services activities and objectives and to prioritize projects according to corporate, regional, and departmental goals.
- Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Requirements:
- Requires a BA/BS in a clinical or health care field (i.e. nursing, epidemiology, health sciences); 5 years of management experience in a health care environment; or any combination of education and experience, which would provide an equivalent background.
- MS or advanced degree in a health care related field (i.e. nursing, health education) or business preferred.
- Previous experience working with NCQA Accreditation and HEDIS preferred.
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.
Our Culture:
We are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes, and drive our shared success – for our consumers, our associates, our communities, and our business.
Benefits:
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.
Hybrid Workforce Strategy:
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.
Equal Employment Opportunity:
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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