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Form of work
Salary- Job Family: Customer Care
- Type: Full time
- Date Posted: Mar 08, 2024
- Anticipated End Date: Apr 01, 2024
- Reference: JR107954
Description
A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
Director Quality Management/Improvement
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.
***This position is hybrid position. The candidate must be able to report to the office a minimum of 1-2 days a week***
***Monday-Friday 8:30 am - 5:00 pm MST
***Candidate must reside in Colorado***
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:
- CQM experience in a Managed Care Organization preferred.
- Population health management and/or clinical quality program development experience preferred.
- MSN, MPH, or MPA preferred.
- Must be knowledgeable and have experience in the following areas: accreditation standards, including National Committee on Quality Accreditation (NCQA) and HEDIS health measures.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $113,148 to $141,435
Locations: Colorado
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
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. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
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 an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
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 elevancehealthjobssupport@elevancehealth.comfor assistance.
