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Staff VP, Carelon Health STARS
3 months ago
Job Description
:Location:
Within 50 miles of a PulsePoint, strong preference to Cerritos, CA.
Summary:
Looking to make a monumental impact in healthcare? Our Staff VP Carelon Health Stars acts as the driving force behind the development, coordination, communication, and strategic execution of top-tier clinical quality management programs for multi-state Medicare and Medicaid markets within Carelon Health.
As a pivotal role within our organization, you'll have the chance to spearhead quality-enhancement campaigns (HEDIS) and launch initiatives that support STARS improvement. Your expertise and leadership will guide Carelon Health to ensure high-quality scores, generating significant revenue enhancements within the markets.
Primary duties may include, but are not limited to:
Drives provider performance improvement for HEDIS, STARS, State Contract Quality & Pay for Performance/Withhold and Medicare Quality metrics.
Foster unity, communication, and collaboration enterprise-wide, promoting the integration and utilization of evidence-based practices.
Advocate for a visionary business approach, leading process improvement activities throughout Carelon Health.
Identify and champion the selection of process improvement activities across Carelon Health.
Assume a key role in Quality Management Scorecards, HEDIS, HOS and CAHPS operations.
Develop strategic HEDIS, CAHPS, VBP goals and objectives, ensures timely completion and develops contingency plans as needed.
Take on a leadership role in new business activities representing Quality Management.
Uphold compliance with National Committee for Quality Assurance (NCQA) standards ensuring an utmost commitment to exceptional quality.
Direct and empower Carelon Health QM committees and leadership meetings.
Hire, train, coach, counsel, and evaluate performance of direct and indirect reporting staff.
Position Requirements:
Requires BS/BA in nursing, public health, healthcare administration, business administration or other health care related field and a minimum of 8 years of experience in a health care environment.
A minimum of 5 years of experience in a managed care organization QM role.
A minimum of 5 years of experience working with government sponsored health care programs; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
Medicare, Medicaid, Commercial Healthplan experience
STARS and HEDIS expertise and understanding patient experience around quality
Experience leading provider group/health plan to a higher STARS rating.
Certified Professional Healthcare Quality (CPHQ).
MS/MA
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $153,600 to $276,480
Locations: California; Colorado; Nevada; New York; Washington State; Jersey City, NJ
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Job Level:
Staff/Regional VPWorkshift:
Job Family:
QLT > Quality MgmtPlease be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
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.
How We Work
At Elevance Health, 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.
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. Applicants who require accommodation to participate in the job application process may contact for assistance.
