EH
Elevance HealthSenior Portfolio Manager
Portfolio Manager Senior overseeing complex project portfolios, ensuring alignment with budget objectives and operational goals at Elevance Health.
About the role
- implements quality improvement programs for all lines of business including annual program description, work plan, and annual evaluation
- works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems
- plays a key role on the NCQA Health Plan accreditation and reaccreditation process
- ensures the Quality Assessment and Performance Improvement (QAPI) program for Humana Healthy Horizons in Oklahoma operates effectively
- drives quality improvement efforts of Humana’s Quality Operations
- supports the implementation and monitoring of program documents such as the program description, work plan, QAPI committee and evaluation
- audits processes as needed for compliance
- completes and submits state or federal reports as required
- collaborates and maintains frequent contact with other managers across departments and health plan
- conducts briefings and area meetings
- determines the plan’s compliance with requirements for NCQA accreditation
- tracks HEDIS measures along with the assistance of the Quality Data Analyst to ensure the plan meets the goals set for quality measure withholds
- coordinates with relevant internal/external stakeholders, providers, state department of health and other entities to maintain quality operations and improve health outcomes
Requirements
- Must reside in the state of Oklahoma
- Bachelor's degree required
- 2+ years of management or leadership experience
- 2+ years of experience in a fast-paced insurance or healthcare setting
- Familiarity with Quality Improvement tools and methodologies (e.g., PDSA, root cause analysis, IHI Model for Improvement, etc.)
- Understanding of healthcare quality measures such as HEDIS, STARS, etc.
- Demonstrated ability to build and maintain strong professional relationships
- Proficient in Microsoft Office Suite, including Word, Excel, and PowerPoint
- Strong analytical and problem-solving skills
- Excellent verbal and written communication skills
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance and many other opportunities
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