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Director Quality Management/Improvement-Behavioral Health Experience Strongly Preferred!

  • Job Family: Customer Care
  • Type: Full time
  • Date Posted:
  • Req #: JR58099


  • Maryland, Baltimore



Responsible for developing, coordinating, communicating, and implementing a strategic quality management and improvement program for a state plan.

How will you make an impact: 

  • Acts as the Quality subject matter expert (SME) supporting continuous quality improvement (CQI) and promotes broad understanding and collaboration across departments, and with external stakeholders.
  • Is accountable for development, measurement strategy and implementation of interventions that support Quality Improvement Activities.
  • Leads development of performance improvement plans and evaluation program.
  • Links strategic efforts with clinical and network to improve experience of care and services of members.
  • Oversees quality complaints and grievances and reporting to the state.
  • Leads audits of delegated services and oversees compliance activities to ensure regulatory and compliance standards are met.
  • Responsible for all KPIs in the contract related to Quality.
  • Leads Health Employer Data Information Sets (HEDIS) reporting and the development of action plans to achieve target improvement goals.
  • Supports the External Quality Review Organization (EQRO) reporting and state audit processes.
  • Provides leadership for QM representation in new business activities.
  • Ensures compliance with National Committee for Quality Assurance (NCQA) standards or other accrediting bodies.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

*Monday -Friday 9 am - 5:30 pm EST**

**Candidate MUST be a resident of Maryland**

**Licensed in the area of Behavioral Health STRONGLY preferred**

Minimum Requirements:

  • Requires a BA/BS in a health or business-related field.
  • 10 years of experience in a healthcare environment, including prior management experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

  • MSN, MPH, or MPA preferred.
  • Licensed in the area of Behavioral Health STRONGLY preferred.
  • CQM experience in a Managed Care Organization preferred.
  • Population health management and/or clinical quality program development experience preferred.

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. A Fortune 20 company with a longstanding history in the healthcare industry, 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 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 – 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 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at 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.

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