Manager I GBD Quality Mgmt - Plan
About The Position
Manager I GBD Quality Management Location: Washington, DC. This role requires associates to be in-office 4 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. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Manager I GBD Quality Management will be responsible for developing, coordinating, and implementing quality initiatives within the health plan. Provides process and technical supervision to a team responsible for monitoring and evaluating the quality of care/service, appropriateness, continuous improvement, member satisfaction, and results of actions across the continuum of care to members. How you will make an impact: Assists in establishing Quality Management objectives and annual goals. Implements the comprehensive Quality Management Program to meet the demographic and epidemiological needs of the population served. Promotes plan-wide understanding, communication, and coordination of the quality management program. Trends quality data and develops aggregate and individual plan reports as indicated; analyzes validity of data/reports. Coordinates the development, implementation, and evaluation of quality improvement action plans. Coordinates the state regulatory quality reporting for the health plan. Hires, trains coaches, counsels, and evaluates performance of direct reports.
Requirements
- Requires an Associate’s degree
- 5 years of experience in quality improvement and/or utilization review in HMO setting, including prior management experience
- or any combination of education and experience, which would provide an equivalent background.
Nice To Haves
- BA/BS, MSN, MPH, or MPA preferred.
- National Committee for Quality Assurance (NCQA) accreditation and Healthcare Effectiveness Data Information Set (HEDIS) reporting experience preferred.
- Urban Medicaid population experience preferred.
- Leadership experience preferred.
- Experience working with Medicaid.
Responsibilities
- Assists in establishing Quality Management objectives and annual goals.
- Implements the comprehensive Quality Management Program to meet the demographic and epidemiological needs of the population served.
- Promotes plan-wide understanding, communication, and coordination of the quality management program.
- Trends quality data and develops aggregate and individual plan reports as indicated; analyzes validity of data/reports.
- Coordinates the development, implementation, and evaluation of quality improvement action plans.
- Coordinates the state regulatory quality reporting for the health plan.
- Hires, trains coaches, counsels, and evaluates performance of direct reports.
Benefits
- 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).
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
