You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
Must reside in Ohio, close to Columbus is preferred.
Position Purpose: Lead and direct process improvement activities that provide more efficient and streamlined workflow.
Bachelor's degree in Nursing, related clinical degree or equivalent experience. 7+ years of quality management, quality improvement or healthcare operations experience. Masters' degree preferred.
- Responsible for leading and collaborating with others on National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance
- Responsible for quality improvement aspects of risk adjustment processes for all products
- Collaborate with Medicare STARS team to improve overall STARS ratings for Medicare products (including HEDIS, CAHPS, HOS)
- Oversee provider satisfaction surveys and implement action plans for improvements
- Research and incorporate best practices into operations
- Organize and control activities, methods, and procedures to achieve business objectives
- Review and implement new technological tools and processes and fosters team concept with internal and external constituencies
- Present results of improvement efforts and ongoing performance measures to senior management
- Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines
License/Certificates: Certain states may require a formal certification in quality improvement, risk management, or another parallel field. Current state's RN license preferred. Certified Professional in Health Care Quality preferred.
Pay Range: $108,700.00 - $201,000.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
