Director, Quality Improvement

Centene Management Company•Des Moines, IA

21h•Hybrid

About The Position

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. This position is responsible for leading and directing process improvement activities that provide more efficient and streamlined workflow. It involves collaborating on NCQA Accreditation and HEDIS performance, overseeing quality improvement aspects of risk adjustment, and improving Medicare STARS ratings. The role also includes managing provider satisfaction surveys, incorporating best practices, implementing new technologies, and presenting results to senior management. The Director will formulate policies and procedures in compliance with guidelines and perform other duties as assigned.

Requirements

Bachelor's Degree in Nursing, other related field or equivalent experience required.
7+ years of quality management, quality improvement or healthcare operations experience required.
Must reside within Iowa or Kansas.

Nice To Haves

Master's Degree preferred.
Current state’s RN license highly preferred.
Certified Professional in Health Care Quality preferred.

Responsibilities

Lead and direct process improvement activities that provide more efficient and streamlined workflow.
Lead and collaborate on National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance.
Oversee 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.
Performs other duties as assigned.
Complies with all policies and standards.