Program Consultant, Quality/Member Rights Specialist

Elevance Health

. Perform quality reporting to DHS, including Critical Incident reporting.

Posted 9/30/2026full-timeWaukesha • Wisconsin • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in external client-facing program management, ensuring compliance with contractual requirements and maintaining member eligibility. Skilled in quality reporting, relationship management, and program development to achieve stated objectives.

Highest-signal resume keywords

External Client-Facing Program ManagementQuality ReportingMember AdvocacyProgram DevelopmentCompliance Management

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality ReportingProgram ManagementBudget DevelopmentProgram Success MeasurementSubject Matter Expertise

Soft Skills

Relationship ManagementTraining CoordinationProblem Solving

Certifications & Qualifications

BA/BS in Related FieldGraduate Degree PreferredProfessional Designation Related to Field

Industry Keywords

DHS ReportingMember RightsIncome EligibilityAppeals and GrievancesIndustry Trends

About the role

Key responsibilities & impact

Perform quality reporting to DHS, including Critical Incident reporting.
Serve as a member advocate and work directly with members to assist with navigating care, appeals and grievances, maintaining income eligibility, and other member rights-related needs.
Ensure the Member Rights Specialist/quality function remains fully independent from other health plan functions.
Work with members, income maintenance agencies, ADRCs, and other partners to gather information needed to maintain member eligibility.
Execute Member Rights Specialist and quality reporting activities within contractually-defined timelines and requirements.
Manage the development, approval, implementation and compliance of ongoing external client-facing programs.
Develop program budget.
Ensure the program meets its stated objectives.
Provide subject matter expertise in response to day-to-day business issues.
Research applicable subject matter practices and remain aware of industry trends.
Manage relationships and partner with corporate and regional business areas.
Coordinate training related to the external client-facing program.
Develop program success measures and perform periodic assessments of program success.

Requirements

What you’ll need

Requires a BA/BS in a related field and minimum of 3 years experience in external client facing program management; or any combination of education and experience, which would provide an equivalent background.
Graduate degree, professional designation related to field or project management experience preferred.
Candidates must reside within a reasonable commuting distance from the posting location(s), unless accommodation is granted as required by law.
New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless an acceptable explanation is provided.

Benefits

Comp & perks

Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical benefits
Dental benefits
Vision benefits
Short-term disability benefits
Long-term disability benefits
401(k) with employer match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources