Job Description
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Role Description
The Clinical Quality Program Manager is responsible for serving as a liaison with and overseeing the quality improvement activities/projects/programs for one or more states within a major line of business.
- This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
- Leads state level quality strategy meetings, develops a quality plan, and ensures integration of quality into the overall business process.
- Works with the clinical intervention team to design studies to identify barriers to medical interventions.
- Ensures that study methodology is sound and appropriate reporting is in place.
- Develops performance improvement plans and oversees the clinical quality improvement activities/projects to improve the quality of care for members.
- 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.
- Qualifications
- 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.
- Requirements
- Physical Therapist or Occupational Therapist preferred.
- Benefits
- Market-competitive total rewards including merit increases, paid holidays, and Paid Time Off.
- 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.
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