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Jobs / Healthcare Quality Improvement Specialist in United States of America
12 days ago
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Elevancehealth·12 days ago
12 days ago

Clinical Quality Program Manager – Pharmacy/Infusion Quality

DURHAM, United States of AmericaFull-timeHybridMid · 5-10 yearsHealthcare Quality Improvement Specialist

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Top 10% of NextRaise users matched against Healthcare Quality Improvement Specialist roles in United States.

Must-have skills for this role

  • quality management system
  • capa
  • data analysis
  • internal auditing

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What you'll do

  • Participates in quality strategy activities and leads assigned quality improvement initiatives, ensuring integration of improvement activities into the overall business process.
  • Lead Quality Management System (QMS) and quality improvement initiatives.
  • Manage Corrective and Preventative Actions (CAPA) activities and performance improvement plans.
  • Support accreditation, regulatory compliance, and quality program requirements.
  • Develop quality metrics, dashboards, scorecards, and performance reports to identify trends and improvement opportunities.
  • Lead internal audits and monitor corrective actions to ensure ongoing compliance.
  • Coordinate quality committees, meetings, documentation, and action item follow-up.
  • Partner with cross-functional teams to implement quality initiatives and improve operational performance.
  • Lead quality-related projects and provide guidance on continuous improvement efforts.

What they're looking for

  • BS in health administration, nursing, or a related clinical field
  • 4 years of health care quality or data analysis experience
  • Any combination of education and experience, which would provide an equivalent background

Nice to have

  • Experience in retail, specialty, or mail-order pharmacy; pharmacy benefit management (PBM); managed care; pharmacy operations; or other highly regulated healthcare environments.
  • Strong written and verbal communication skills, including the ability to effectively communicate findings, recommendations, and performance results to key stakeholders and leadership.
  • Experience supporting regulatory, contractual, accreditation, compliance, or quality assurance programs.
  • Advanced Microsoft Excel skills and experience with quality reporting and analytics.
  • CPHQ, Lean Six Sigma, PMP, CPHT, or other quality, project management, or healthcare certifications preferred.

Summarised by NextRaise from the employer’s description, which follows in full below.

Full description from employer

Anticipated End Date:

2026-09-23

Position Title:

Clinical Quality Program Manager – Pharmacy/Infusion Quality

Job Description:

Clinical Quality Program Manager – Pharmacy/Infusion Quality

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. Alternate locations may be considered if candidates reside within a commuting distance from an office.

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.

The Clinical Quality Program Manager - Pharmacy/Infusion Quality leads quality improvement programs, Quality Management System (QMS) initiatives, and regulatory compliance activities supporting pharmacy and clinical infusion services. This role partners with Pharmacy Operations, Clinical Services, Compliance, and business leaders to drive continuous improvement, accreditation readiness, operational excellence, and quality outcomes.

How you will make an impact:

  • Participates in quality strategy activities and leads assigned quality improvement initiatives, ensuring integration of improvement activities into the overall business process.
  • Lead Quality Management System (QMS) and quality improvement initiatives.
  • Manage Corrective and Preventative Actions (CAPA) activities and performance improvement plans.
  • Support accreditation, regulatory compliance, and quality program requirements.
  • Develop quality metrics, dashboards, scorecards, and performance reports to identify trends and improvement opportunities.
  • Lead internal audits and monitor corrective actions to ensure ongoing compliance.
  • Coordinate quality committees, meetings, documentation, and action item follow-up.
  • Partner with cross-functional teams to implement quality initiatives and improve operational performance.
  • Lead quality-related projects and provide guidance on continuous improvement efforts.

Minimum Requirements:

Requires a BS in health administration, nursing, or a related clinical field; 4 years of health care quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities & Experiences:

  • Experience in retail, specialty, or mail-order pharmacy; pharmacy benefit management (PBM); managed care; pharmacy operations; or other highly regulated healthcare environments.
  • Strong written and verbal communication skills, including the ability to effectively communicate findings, recommendations, and performance results to key stakeholders and leadership.
  • Experience supporting regulatory, contractual, accreditation, compliance, or quality assurance programs.
  • Advanced Microsoft Excel skills and experience with quality reporting and analytics.
  • CPHQ, Lean Six Sigma, PMP, CPHT, or other quality, project management, or healthcare certifications preferred.

Job Level:

Non-Management Exempt

Workshift:

1st Shift (United States of America)

Job Family:

QLT > Clinical Quality

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 should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. 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.


Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.


NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.

Company

Elevancehealth
DURHAM, United States of America

Company facts come from this company's own listings. We only show what the postings themselves carry.

Sourced from Elevancehealth's careers site·first seen 9 Sept 2026·last verified 9 Sept 2026·How we source jobs

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