Director, Quality & Process Improvement

Centene Corporation•Northampton, MA

About The Position

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. Position Purpose: Lead and direct process improvement initiatives by utilizing process improvement methodologies in the analysis of current operations and design of improvement projects across all areas that impact operations. This Director will be accountable for managing the end-to-end NCQA audit timeline and ensuring the organization successfully passes audit each year. Oversee the administration, coordination and evaluation of quality assurance and training, including policy and procedure development, training assessments and quality adherence auditing Direct the execution of performance improvement projects, including process mapping and process design Create and maintain dashboards, communications, and strategies to improve effectiveness Research and develop best practices, policies, procedures, and goals in compliance with internal and external guidelines Oversee data analysis and gathering processes and programs to establish costs and benefits of process effectiveness and efficiency Ensure business unit is compliant with URAC and Joint Commission Accreditation standards Review and implement new technological tools and processes Establish strong collaborative relationships with all functional units and their leaders

Requirements

Bachelors Degree in related field.
6+ years of quality and process improvement experience.
Healthcare industry experience preferred.
Knowledge of research methodologies including measures and outcomes; knowledge of process mapping, process design, and workflow management software and applications.
URAC and Joint Commission Accreditation experience preferred.
Deep experience leading end-to-end HEDIS audits and managing NCQA timelines highly preferred.

Nice To Haves

Six Sigma/LEAN Certification preferred.

Responsibilities

Lead and direct process improvement initiatives by utilizing process improvement methodologies in the analysis of current operations and design of improvement projects across all areas that impact operations.
Accountable for managing the end-to-end NCQA audit timeline and ensuring the organization successfully passes audit each year.
Oversee the administration, coordination and evaluation of quality assurance and training, including policy and procedure development, training assessments and quality adherence auditing
Direct the execution of performance improvement projects, including process mapping and process design
Create and maintain dashboards, communications, and strategies to improve effectiveness
Research and develop best practices, policies, procedures, and goals in compliance with internal and external guidelines
Oversee data analysis and gathering processes and programs to establish costs and benefits of process effectiveness and efficiency
Ensure business unit is compliant with URAC and Joint Commission Accreditation standards
Review and implement new technological tools and processes
Establish strong collaborative relationships with all functional units and their leaders