Clinical Quality Program Specialist - MyCare Ohio

Anticipated End Date:

2025-09-20

Position Title:

Clinical Quality Program Specialist - MyCare Ohio

Job Description:

Be Part of an Extraordinary Team

The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.

Clinical Quality Program Specialist

Location: This position is based in Ohio; the associate will report to one of our 4 office locations below:

• 3075 Vandercar Way, Cincinnati, OH 45209

• 8940 Lyra Drive, STE 300, Columbus, OH 43240

• 4361 Irwin Simpson Raod, Mason, OH 45040

• 6000 Lombardo Center, STE 200, Seven Hills, OH 44131

In Office Expectation: Hybrid 1; This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Shift & Hours: Monday-Friday, 8:00 AM - 5:00 PM Eastern Time  

The Clinical Quality Program Specialist is responsible for supporting projects and assisting the quality improvement activities and programs for and/or on behalf of the Health Plan.

How You Will Make an Impact

Primary duties may include, but are not limited to:

• Build and maintain project plan and schedule for projects that support the quality strategy, contributes to ensuring project deliverables are met, assist in documentation and project status tracing.

• Ensures integration of quality into the overall business process.

• Monitor activities to ensure project objectives are met within established time frames and budgets.

• Assists with compliance of corporate Quality Improvement (QI) work plans.

• Supports Clinical Quality Program with maintaining effective documentation to meet regulatory and Accreditation Standards.

• Conducts accurate and complete quantitative analysis of clinical data and presentation of results.

• Additional responsibilities will include scheduling, conducting and attending meetings, supporting management in overall objectives, assessing costs and savings.

Minimum Requirements:

• Requires 2 years of health care quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, & Experiences:

• Knowledge of Ohio Medicare and Medicaid regulations strongly preferred.

• Quality improvement background preferred.

• BS in health administration, nursing or a related clinical field or current unrestricted license or certification in applicable field preferred (i.e. CPHQ).

• MS in the health field (i.e. Nursing) preferred.

Job Level:

Non-Management Exempt

Workshift:

1st Shift (United States of America)

Job Family:

QLT > Clinical Quality

Please 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 pr