Clinical Quality Program Manager
Elevance Health

Location: Wichita KS, Topeka KS, Kansas City KS

Hours: Monday - Friday

Travel: Hybrid (1-2 days per week in office)

Position Overview:

Responsible for creating and facilitation training strategies/programs to support an operational team responsible for abstraction and pursuit of HEDIS® measures to ensure they reach operational milestones, gap closures, rates and overall successful quality standards

How You Will Make an Impact:

• Manages, coordinates and facilitates HEDIS® training, including HEDIS® software training, admin and hybrid measure training and creating training materials
  
• Coordinates training related to external client facing program; develops program success measures and performs periodic assessments of program success.
  
• Assures compliance with corporate QI work plans.
  
• Assures that all QI activities are relevant to the needs of targeted population.
  
• Maintains effective documentation of research programs to meet regulatory and Accreditation Standards.
  
• Provides oversight to assure accurate and complete quantitative analysis of clinical data and presentation of data analysis results.
  
• Participates in and provides input to the development of new product designs for major line of business.
  
• Oversees the implementation of new initiatives.
  
• Leads interactions with regulators or oversight entities.
  
• Oversees quality improvement activities for the largest, most complex state programs.
  

• Requires a BS in health administration, nursing, or a related clinical field; 4 years of health care quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.
  

• Previous HEDIS® measure training experience including HEDIS® software workflow development
  
• Previous experience working with HEDIS chart retrieval, abstraction and over-reading
  
• Previous experience working Cotiviti HEDIS software is strongly preferred
  
• Expert knowledge with HEDIS® technical specifications preferred
  
• Expert knowledge with HEDIS® value sets and coding preferred
  
• Project management certification preferred