AddressDescription
Quality Evaluator Senior
Location : This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.
The QUALITY EVALUATOR SENIOR is responsible for supporting the site-specific HMC Quality programs by executing and evaluating the Quality Standard Operating Procedures (SOP), preparing trend reports and making process improvement recommendations to HMC Care Center Management.
How you will make an impact:
- Responsible for care center training and the preceptor program, conducting the quality calibration process and acts as a preceptor to new Quality Evaluators or Quality Evaluators in need of performance improvement.
- Develops and reports the Quality Evaluator performance scorecard results to Quality Director and Care Center Management.
- Assesses the content of scorecard results and develops work plan assignments for Care Center Management.
- Responsible for conducting random chart audits on assigned teams and providing management with a monthly report on the chart audits.
- May perform quality evaluations.
Minimum Requirements:
- Requires BA/BS in nursing, social work, respiratory therapy or related clinical field and minimum of 5 years of experience in managed care which includes progressive experience in clinical staff development and education, quality; or any combination of education and experience, which would provide an equivalent background.
- Current unrestricted license in applicable state(s) for designated field (i.e. RN, Social Work, Respiratory Therapy) required.
Preferred Skills, Capabilities and Experiences :
- Clinically relevant certification (i.e. Certified Diabetes Educator, Certified Case Manager) and a background in quality or performance improvement preferred.
- RN's, Licensed Physical Therapist, and Occupational Therapists preferred.
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.
