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Centene Corporation

Senior Director, Quality Improvement

Posted 2 Days Ago
Be an Early Applicant
Remote
6 Locations
139K-256K Annually
Senior level
Remote
6 Locations
139K-256K Annually
Senior level
Lead process improvement activities, ensuring NCQA accreditation and compliance while managing clinical data analysis and refining operational workflows.
The summary above was generated by AI

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.
 

Remote OpportunityIdeal candidate will have background in HEDIS Operations and Risk Adjustment with experience in clinical data analysis, claim and metric/dashboard tracking.

Position Purpose:
Lead and direct process improvement activities that provide more efficient and streamlined workflow.

  • Responsible for National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance.
  • Ensure health plan is compliant and become/remain accredited with NCQA
  • 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. • Research and incorporate best practices into operations.
  • Organize and control activities, methods, and procedures to achieve business objectives.
  • Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Education/Experience:
Bachelor's degree in Nursing, other related field or equivalent experience. Master's’ degree preferred. 7+ years of healthcare operations experience, including quality improvement experience.
License/Certification: RN license preferred. Certified Professional in Health Care Quality preferred.
 

Pay Range: $138,700.00 - $256,300.00 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, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Top Skills

Claims Tracking
Clinical Data Analysis
Dashboard Tracking
Hedis
Metric Tracking
Ncqa
Technological Tools

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