Clinical Quality and Population Health- Project Manager for Ohio Market

Be Part of an Extraordinary Team

The MyCare Ohio Plan program is to deliver high-quality, trauma informed, culturally competent, person-centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.

Project Manager

Location: 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. When reporting to the office, the office assigned is OH-COLUMBUS, 8940 LYRA DR, STE 300. Alternate Office locations within Ohio may be considered if candidates reside within a commuting distance from an Ohio office. Travel within the state of Ohio as needed may be required.

*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.

Schedule: This position will work a first shift from 8:00 am- 5:00 pm EST Monday thru Friday.

The Project Manager is responsible for working with business partners to identify and implement medium to large projects that support achievement of simple to complex non-clinical and clinical quality improvement activities/projects to improve the quality of care for members. Projects may be business and/or technical (software implementation or application updates) in nature. Works with moderate guidance and is responsible for applying project management knowledge, skills, tools and techniques to project deliverables, processes, and systems. Operates within defined parameters using project management methodology.

Primary duties may include, but are not limited to:

• Manages the development of a prescribed planning document.

• Develops project charter.

• Partners with sponsors to secure project approval.

• Leads interactions with regulators or oversight entities.

• Develops communication management plan.

• Defines project team roles and responsibilities, develops work plan structure and project schedule.

• Develops deployment plan.

• Leads project meetings.

• Identifies, documents and prioritizes scope changes and facilitates approval process.

• Maintains and updates all project documents and maintains effective documentation of research programs to meet regulatory and Accreditation Standards.

• Secures the appropriate skill sets for project.

• Sets and manages expectations with resource managers and team members.

• Provides performance feedback to team members and resource managers.

• Maintains issue log and facilitates resolution of issues.

• Executes communication plans and regularly reports status.

• Manages and monitors ROI throughout the project lifecycle.

• Tracks and manages time and budget against plan.

• Develops testing strategy.

• Conduct project close-out activities and prepares and participates in quality review checkpoints.

• Obtain/secure and archive necessary approvals.

• Manage and update project plan.

• Assists with compliance of Quality Improvement (QI) work plans and projects.

• Supports health plan in maintaining effective documentation to meet regulatory and Accreditation Standards.

• Conducts accurate and complete quantitative analysis of clinical data and presentation of results.

• Developing, implementing, and evaluating gap closer initiatives.

• Monitors and develops opportunities to increase Stars ratings.

• Monitor population health trends.

• Lead multi-functional teams through quality improvement projects to increase health outcomes for special populations.

• Improve health plan ratings and close HEDIS measures.

Minimum Requirements:

• Requires a BA/BS in a related field and minimum of 3 years professional project management experience, which at least 2 years are spent leading and directing project tasks; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Demonstrated ability to create an effective team environment, build strong relationships, solving problems and issues in a matrix environment and communicating effectively at all levels of an organization is strongly preferred.

• Project Management Professional (PMP) certification preferred.

• Experience working in a lead role on one or more projects strongly preferred.

• Certification in applicable field (CPHQ) preferred.

• Knowledge and experience working with Ohio Medicare and/or Medicaid regulations strongly preferred.

• Quality improvement background preferred or knowledge around IHI training preferred.

• Experience navigating and interpreting quality/HEDIS measures and NCQA standards preferred.

• Knowledge of Ohio Quality Withhold Collaboratives preferred.

• Experience improving health outcomes through quality improvement and population health initiatives preferred.

• Knowledge and experience with NCQA Accreditation requirements preferred.

• Knowledge and experience with Ohio Population Health stair step approach to improving health and wellness for Ohio population and designated population health streams is strongly preferred.

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 is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and 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, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.