Clinical Quality Program Director

Anticipated End Date:

2025-06-20

Position Title:

Clinical Quality Program Director

Job Description:

Clinical Quality Program Director 

Location: Ohio. This role requires associates to be in-office 3 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. Alternate locations may be considered.

*Candidate MUST be a resident in the state of Ohio.*

The Clinical Quality Program Director  is responsible for developing a national quality improvement strategy for a major line of business.

 

How will you make an impact: 

• Leads enterprise-wide quality strategy meetings. Develops and facilitates the integration of a national quality plan.
• Identifies and integrates best practices into state programs.
• Develops performance improvement plans and oversees the clinical quality improvement activities/projects.
• Participates in the development, management, review, and reporting of program outcomes for clinical quality programs.
• Assures compliance with corporate Quality Improvement work plans.
• Ensures research program documentation meets regulatory and Accreditation Standards.
• Assures accurate and complete quantitative analysis of clinical data.
• Leads department projects and mentors’ staff.
• Prepares and presents program documents to senior management.

Minimum Requirements:

• Requires a BS in health administration, nursing or a related clinical field; 5 years of health care quality or data analysis experience; or an equivalent combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Advance knowledge of Medicaid/Medicare guidelines for the state of Ohio strongly preferred.
• Minimum 5 yrs HEDIS experience strongly preferred.
• Current unrestricted license or certification in an applicable field (i.e. CPHQ) or MS in the health field (i.e. Nursing) strongly preferred.
• Knowledge of state or assigned line of business needs and priority improvement areas strongly preferred.

Job Level:

Director Equivalent

Workshift:

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 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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing rol