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Quality Evaluator Sr (US)

Location:

  • GA, Atlanta

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Description

Location : Remote, candidate must be located in Georgia.

Hours: Standard Business Hours.

Responsible for supporting the site-specific GFC 360 HM Quality programs by executing and evaluating the Quality Standard Operating Procedures (SOP), preparing trend reports and making process improvement recommendations to HMC Care Center Management.

Primary duties may include, but are not limited to:

  • Responsible for care center training and the preceptor program, conducting the quality calibration process and acts as a preceptor to new Quality Evaluators or Quality Evaluators in need of performance improvement.

  • Develops and reports the Quality Evaluator performance scorecard results to Quality Director and Care Center Management.

  • Assesses the content of scorecard results and develops work plan assignments for Care Center Management.

  • Responsible for conducting random chart audits on assigned teams and providing management with a monthly report on the chart audits.

  • May perform quality evaluations.

Required Qualifications:

  • BA/BS in nursing, social work, respiratory therapy or related clinical field and minimum of 5 years of experience in managed care which includes progressive experience in clinical staff development and education, quality; or any combination of education and experience, which would provide an equivalent background.

  • Current unrestricted license in applicable state(s) for designated field (i.e. RN, Social Work, Respiratory Therapy).

Preferred Qualifications:

  • Knowledge of the child welfare system, Have the CPHQ certification or is working towards the certification


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. 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 ability@icareerhelp.com for assistance.

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