Clinical Quality Director â Stars/HEDIS
Clinical Quality Director â Stars/HEDIS
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Job Description
Anticipated End Date:
Position Title:
Clinical Quality Director Stars/HEDISJob Description:
Clinical Quality Director Stars/HEDIS
Location: Alternate locations may be considered. This position will work a hybrid model (remote and office). The ideal candidate will live within a commutable distance from our PulsePoint locations.
CareBridge Health is a proud member of the Elevance Health family of companies within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health independence and quality of life through home-care and community based services.
The Clinical Quality Director is responsible for working with the regional head of health care management to direct the clinical quality initiatives including NCQA accreditation and compliance with regulatory agencies and other objectives. The ideal candidate brings a track record of driving 4- to 5-Star performance through successful Stars and HEDIS gap closure initiatives with experience spanning diverse population segments and quality measures.
How you will make an impact:
Works with both internal and external customers to promote understanding of health services activities and objectives within the company and to prioritize departmental projects according to Elevance Health corporate regional and departmental goals.
Maintains expert knowledge of current industry standards quality improvement activities and strong medical management skills.
Assures the training and continuing education of staff regarding standards and guidelines including NCQA and HEDIS.
Hires trains coaches counsels and evaluates the performance of direct reports.
Minimum Requirements:
Requires BA/BS in a clinical or health care field (i.e. nursing epidemiology health sciences) and 5 years progressively responsible management experience in a health care environment or any combination of education and experience which would provide an equivalent background.
Preferred Skills Capabilities and Experience:
MS or advanced degree in a health care related field (i.e. nursing health education) or business strongly preferred.
Previous experience working with NCQA and HEDIS preferred.
Excellent written oral presentation and interpersonal communication skills with the proven ability to negotiate preferred.
Proficient of Microsoft Office products most notably in PowerPoint Teams OutlookExcel and Word strongly preferred.
Job Level:
DirectorWorkshift:
1st Shift (United States of America)Job Family:
QLT > Clinical QualityPlease 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 roles to become vaccinated against COVID-19 and Influenza. 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 for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Required Experience:
Director
Employment Type
Full-Time
