Clinical Quality Program Manager
for section headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections that have real specific content. Must not repeat job title as heading. Must not include Job ID etc. Must preserve all substantive info, no invention, no summarizing away detail. Remove boilerplate, navigation, legal, EEO, scam warning, duplicated lines, application instructions. Also must not create Pay/Schedule/Benefits sections unless posting actually states them. The posting includes salary range and benefits description, and work shift (Monday-Friday 8:30-5:00 EST) and hybrid location info. So we can have sections: About the role (maybe description of role), Responsibilities (the bullet list of duties), Requirements (minimum requirements), Qualifications (maybe license/certification?), Skills (preferred skills), Benefits (benefits package description), Pay (salary range), Schedule (work shift and hybrid schedule). Need to ensure we don't create sections with filler like "commensurate with experience". We have actual content. We must preserve all substantive information; do not invent or summarize away detail. So we need to include details like: "Individual Contributor Role", location hybrid 1-2 days per week, etc. Also mention "Current unrestricted license related to the medical or behavioral health field, or certification in applicable field (i.e. CPHQ)". Also mention "Work Shift: Monday – Friday, 8:30 am to 5:00 pm (EST)". Also mention "Location: Columbus, OH". Also mention "Hybrid 1 - This role requires associates to be in-office 1 - 2 days per week...". Also mention "A proud member of the Elevance Health family of companies, Carelon Behavioral Health...". Also mention "Born out of one of the largest healthcare systems organization in the United States...". Also mention "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." Then "How You Will Make An Impact" bullet list. Then "Minimum Requirements" bullet list. Then "Preferred Skills, Capabilities And Experiences". Then salary range and benefits description. Also mention "In addition to your salary, 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)." Also mention "The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company." etc. That's a lot of text; we need to preserve all substantive info, but we can condense? The instruction says "Do NOT invent or summarize away detail." That suggests we should not omit details; we need to keep them. However we can keep them as prose within
tags. Summarizing away detail would be removing specifics; we must keep them. So we need to include all the details, but we can keep them in paragraphs. We must not create sections with filler. So we need to include all the content, but we can organize into sections. We must not include boilerplate like EEO, equal-opportunity, scam-warning, legal, navigation, cookie, application instructions. So we need to strip those paragraphs. Let's identify substantive content: - Must Have a Current unrestricted license related to the medical or behavioral health field, or certification in applicable field (i.e. CPHQ). This is an Individual Contributor Role. - Location: Hybrid 1 - This role requires associates to be in-office 1 - 2 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. 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 accommodation is granted as required by law. - A proud member of the Elevance Health family of companies, Carelon Behavioral Health uses our powerful combination of experience, expertise, dedication and compassion to see what's possible and what's better. Born out of one of the largest healthcare systems organization in the United States, our rich history gives us a unique and valuable perspective on how to solve the most pressing healthcare challenges. - Work Shift: Monday – Friday, 8:30 am to 5:00 pm (EST) - 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. - How You Will Make An Impact (list): - Participates in quality strategy activities and leads assigned quality improvement initiatives, ensuring integration of improvement activities into the overall business process. - Leads root cause analyses to identify drivers of HEDIS performance gaps and develops data-informed recommendations and intervention strategies. - 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. - Partners with Analytics and cross-functional stakeholders to develop reporting, interpret HEDIS data, and identify opportunities for quality improvement. - Oversees the implementation of new initiatives. - Leads interactions with regulators or oversight entities. - Oversees quality improvement activities for the largest, most complex state programs. - Minimum Requirements: - 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. - Current, unrestricted license related to the medical or behavioral health field, or certification in applicable field (i.e. CPHQ). - Preferred Skills, Capabilities And Experiences: - MS in the health field (i.e. Nursing) is preferred. - HEDIS knowledge and experience supporting HEDIS quality improvement initiatives highly preferred. - Experience interpreting healthcare quality data to identify trends, root causes, and improvement opportunities preferred. - For candidates working in person or virtually in the below location, the salary* range for this specific position is $85,920 to $128,880 - Location: Columbus, OH - In addition to your salary, 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). - The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. - The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. - The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. - Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. - No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. - The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. - 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 description) - maybe we can include as About the role? Actually "Who We Are" is about the company, could be part of About the role or separate. But we have limited headings; we can put company description under About the role. - How We Work (culture, values, total rewards, hybrid workforce strategy, vaccination requirement, etc.) - some of that may be considered boilerplate? It's about company culture, benefits, etc. Might be considered substantive but could be considered boilerplate? The instruction says remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. The "How We Work" section includes culture, values, total rewards, hybrid workforce strategy, vaccination requirement. Some of that may be considered not boilerplate but still part of job posting. However we need to decide if we include it. The instruction says preserve ALL substantive information; do NOT invent or summarize away detail. So we should keep it unless it's clearly boilerplate like EEO, legal, etc. The "How We Work" includes description of culture, values, total rewards, hybrid workforce strategy, vaccination requirement. That seems substantive. However we have limited headings; we could incorporate into About the role or Benefits or maybe a separate section like "Company Overview". But we only have allowed headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We could put company description under About the role. The total rewards and hybrid workforce strategy could go under Benefits or Schedule? Benefits already covers benefits package; hybrid workforce strategy could go under Schedule (since it's about work location). Vaccination requirement maybe could be under Requirements? But it's not a requirement for the role per se, it's a condition of employment. Might be considered a requirement. However we have to be careful not to invent sections. We could add a paragraph under About the role that includes company description and culture. Or we could add a separate
after sections. But the instruction: "Use