Clin Prog Dev Manager (US)

Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. Elevance Health supports a hybrid workplace model (virtual and office) with PulsePoint sites used for collaboration, community, and connection, with the minimum in-office commitment being 1-3 days in an office per week. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. Responsible for monitoring quality performance data, and managing clinical program development for population-based clinical quality measures, focusing on HEDIS. PRIMARY DUTIES: Evaluates industry best practices, medical research and other resources to develop clinical programs and tools which facilitate and support quality, cost-effective care. Develops and implements an annual plan detailing the strategies, programs and tools to be implemented. Leads program development activities. Develops and coordinates presentations, communications and implementation for all phases of the clinical programs/tools development and implementation. Ensures all programs and tools are compliant with regulatory directives and state/federal laws and policies. Identifies system needs to implement clinical programs. Develops system requirements and ROI. Tracks program performance and results and modifies as needed. Provides leadership and guidance to associates involved in program development and implementation activities. Minimum Requirements: BA/BS in business, public health, nursing, epidemiology, biostatistics, or related field and minimum of 5 years experience involving analyses of health care data and clinical program development; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities and Experience: MS in public health, health services administration, nursing, or business administration preferred. Strong knowledge around HEDIS and STARS measures including HEDIS specifications and NCQA/CMS coding guidelines. Proficient in creating and delivering PowerPoint presentations to Senior Leadership. Excel and Tableau proficiency strongly preferred. Experience with Medicare Advantage and Special Needs Plans and Programs preferred. For candidates working in person or remotely in the below location(s), the salary range for this specific position is $102,672 to $160,704. Locations: California; New York 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). Elevance Health #J-18808-Ljbffr

Created: 2025-02-01