Mgr Assoc Clinical Quality

Description

The Mgr Assoc Clinical Quality is responsible for developing work plans and interventions for quality improvement activities. Performs analysis, prepares reports and presents findings. Primary duties may include, but are not limited to:

• Analyzes data from various sources and develops new measurement strategies and means for evaluation.
• Develops Quality Improvement strategies by analyzing data and observing service, utilization, and quality of care gaps.
• Applies appropriate statistical techniques and methodology to suggest performance improvement opportunities and targets.
• Leads cross-departmental teams in designing interventions.
• Develops measurement and evaluation plans.
• Designs and submits measures specifications and updates specifications as business needs or compliance criteria change.
• Creates custom reports and reviews reports for quality assurance.
• Adapts interventions across health plans to meet client needs.
• Develops data management system to monitor, analyze, evaluate, and trend quality improvement projects.
• Generates reports of data analyses, including both written analysis and graphical presentation of data.
• Utilizes comparative measures, benchmarks, and targets to evaluate improvement.
• Supports reporting requirements for NCQA, EQRO and other accrediting agencies.
• Communicates findings and analysis and generates original reports to be utilized in Quality Management and Quality improvement cycle.
• Supports Provider Quality in Quality Improvement projects by assisting with data analysis.
• Participates in client appointments, develops PowerPoints, and presents to stakeholders.
• Writes reports for contract deliverables and delegation agreements.
• Manages and works on special projects.
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.
• Travel may be required.

Requirements:

• MA/MS in Public Health, healthcare or other relevant field and a minimum of 5 years experience in healthcare; or any combination of education and experience which would provide an equivalent background.
• Experience in data analysis, quality improvement activities and NCQA preferred.
• Experience with chart auditing 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 careers.ElevanceHealth.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.