Clinical Quality Program Manager
Location: Wichita KS, Topeka KS, Kansas City KS
Hours: Monday - Friday
Travel: Hybrid (1-2 days per week in office)
Job Description:
Responsible for creating and facilitating training strategies/programs to support an operational team responsible for abstraction and pursuit of HEDIS measures to ensure they reach operational milestones, gap closures, rates, and overall successful quality standards.
How You Will Make an Impact:
- Manages, coordinates, and facilitates HEDIS training, including HEDIS software training, admin and hybrid measure training, and creating training materials.
- Coordinates training related to external client-facing program; develops program success measures and performs periodic assessments of program success.
- 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.
Required 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.
Preferred Qualifications:
- Previous HEDIS measure training experience including HEDIS software workflow development.
- Previous experience working with HEDIS chart retrieval, abstraction, and over-reading.
- Previous experience working Cotiviti HEDIS software is strongly preferred.
- Expert knowledge with HEDIS technical specifications preferred.
- Expert knowledge with HEDIS value sets and coding preferred.
- Project management certification preferred.
Job Level: Non-Management Exempt
Workshift: 1st Shift (United States of America)
Job Family: QLT > Clinical Quality
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.
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.
#J-18808-Ljbffr
