Job Details

Clinical Quality and Population Health- Project Manager for Ohio Market

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

Location: This role requires associates to be in-office 1–2 days per week, fostering collaboration and connectivity while allowing flexibility to support productivity and work-life balance. The office is OH-COLUMBUS, 8940 LYRA DR, STE 300. Alternate Ohio office locations 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.

Schedule: This position works a first shift from 8:00 am–5:00 pm EST Monday through Friday.

Hybrid Work Policy: 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.

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 the 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.
• Conducts project close‑out activities and prepares and participates in quality review checkpoints.
• Obtains/secures and archives necessary approvals.
• Manages and updates 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.
• Develops, implements, and evaluates gap‑closer initiatives.
• Monitors and develops opportunities to increase Star ratings.
• Monitors population health trends.
• Leads multi‑functional teams through quality improvement projects to increase health outcomes for special populations.
• Improves health plan ratings and closes HEDIS measures.

Minimum Requirements

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

Preferred Skills, Capabilities, and Experiences

• Demonstrated ability to create an effective team environment, build strong relationships, solve problems and issues in a matrix environment, and communicate effectively at all levels.
• Project Management Professional (PMP) certification preferred.
• Experience working in a lead role on one or more projects preferred.
• Certification in applicable field (CPHQ) preferred.
• Knowledge and experience with Ohio Medicare and/or Medicaid regulations preferred.
• Quality improvement background or knowledge of 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 of NCQA Accreditation requirements preferred.
• Knowledge of Ohio Population Health step‑step approach and designated population health streams 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.

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 ...@elevancehealth.com 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.

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