Clinical Quality Program Manager - Pharmacy/Infusion Quality

Elevance Health (Anthem); Durham (NC); Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Merit increases

Paid holidays

Paid Time Off

Bonus programs

Medical

Dental

Vision

Short and long term disability

401(k) + match

Stock purchase plan

Life insurance

Wellness programs

Job summary

Elevance Health seeks a Clinical Quality Program Manager to lead quality improvement initiatives across pharmacy and infusion quality. The role partners with cross-functional teams to drive QMS and ensure regulatory compliance and accreditation readiness.

This non-management exempt position emphasizes data-driven quality reporting, actionable metrics, and continuous improvement within a hybrid work model.

Qualifications

• 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.

Responsibilities

• Participates in quality strategy activities and leads assigned quality improvement initiatives.
• Lead Quality Management System (QMS) and quality improvement initiatives.
• Manage CAPA activities and performance improvement plans.
• Support accreditation, regulatory compliance, and quality program requirements.
• Develop quality metrics, dashboards, scorecards, and performance reports.
• Lead internal audits and monitor corrective actions to ensure compliance.
• Coordinate quality committees and cross-functional meetings.

Skills

Quality analytics

Advanced Excel

Clear communication

Quality reporting

Project management

Education

BS in health administration or related clinical field

Tools

Microsoft Excel

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.

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

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.

Benefits

• 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, 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 onsi