Centene Corporation-posted 2 days ago
$86,000 - $154,700/Yr
Full-time • Manager
Remote
5,001-10,000 employees

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. This is a remote role with oversight of a Medicare team driving CAHPS and HOS quality improvement strategies and collaborating across teams to drive initiatives that enhance quality ratings and health outcomes. Experience driving CAHPS/ HOS initiatives is highly preferred. Position Purpose: Oversee and manage the functions of the quality improvement program. Providing support to staff and communicate with departments and staff to facilitate daily quality improvement (QI) functions. Review and analyze reports, records and directives. Confer with staff to obtain data such as new projects, status of work in progress, and problems encountered, required for planning work function activities. Verify data to be submitted in accordance with government program requirements and ensure compliance with state, federal and certification requirements. Prepare reports and records on work function activities for management. Oversee the review and analysis of reports. Evaluate current procedures and practices for accomplishing the assigned work functions objectives to develop and implement improved procedures and practices and to ensure compliance with required standards. Collaborate with appropriate departments to document, investigate and resolve formal or informal complaints and appeals in accordance with Company and State policies, procedures and requirements. Monitor and analyze costs and participate in the preparation of the budget.

  • Oversee and manage the functions of the quality improvement program.
  • Provide support to staff and communicate with departments and staff to facilitate daily quality improvement (QI) functions.
  • Review and analyze reports, records and directives.
  • Confer with staff to obtain data such as new projects, status of work in progress, and problems encountered, required for planning work function activities.
  • Verify data to be submitted in accordance with government program requirements and ensure compliance with state, federal and certification requirements.
  • Prepare reports and records on work function activities for management.
  • Oversee the review and analysis of reports.
  • Evaluate current procedures and practices for accomplishing the assigned work functions objectives to develop and implement improved procedures and practices and to ensure compliance with required standards.
  • Collaborate with appropriate departments to document, investigate and resolve formal or informal complaints and appeals in accordance with Company and State policies, procedures and requirements.
  • Monitor and analyze costs and participate in the preparation of the budget.
  • Bachelor’s degree in related field or equivalent experience.
  • 3+ years clinical, quality management or healthcare related experience and 1 year of recent quality improvement and supervisory experience in a healthcare environment, preferably managed care.
  • Current state registered nursing license preferred.
  • Certain states may require a formal certification in quality improvement, risk management, or another parallel field.
  • Certified Professional in Healthcare or other licensed clinical experience preferred.
  • Experience driving CAHPS/ HOS initiatives is highly preferred.
  • competitive pay
  • health insurance
  • 401K and stock purchase plans
  • tuition reimbursement
  • paid time off plus holidays
  • a flexible approach to work with remote, hybrid, field or office work schedules
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