Clinical Quality Program Manager

Elevance Health

Clinical Quality Program Manager overseeing state level quality strategy meetings and healthcare improvement initiatives. Focused on quality integration and compliance for Elevance Health services.

Posted 6/25/2026full-timeWest Chester • Pennsylvania • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

Requires a BS in health administration, nursing, or a related clinical field
4 years of health care quality or data analysis experience
Current unrestricted license, certification in applicable field (i.e. CPHQ) and/or a MS in the health field (i.e. Nursing) is preferred
Candidates must reside in Pennsylvania, near West Chester, PA and be within a reasonable commuting distance of an Elevance Health PulsePoint office.

Benefits

Comp & perks

merit increases
paid holidays
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
financial education resources

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

quality improvementdata analysisperformance improvementstudy methodologyquantitative analysisclinical quality improvementregulatory compliancedocumentationhealth administrationclinical intervention

Soft Skills

leadershipcommunicationorganizational skillscollaborationoversightstrategic planningproblem-solvingattention to detailadaptabilitystakeholder engagement

Certifications

CPHQunrestricted licenseMS in health field