Manager, Quality Improvement

Centene Corporation

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. Kentucky lines of business (Medicaid, Marketplace, Medicare Regulatory compliance and accreditation lines knowledge Position Purpose: Oversee and manage the functions of the quality improvement program, including HEDIS reporting and other quality improvement activities. 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, including HEDIS reporting. 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. Manage delegate vendor oversight and corrective action plans as indicated. Monitor and analyze costs and participate in the preparation of the budget. Performs other duties as assigned Complies with all policies and standards Kentucky lines of business (Medicaid, Marketplace, Medicare Regulatory compliance and accreditation lines knowledge

Requirements

Bachelor’s degree in health related field or equivalent experience.
4+ years of quality improvement.

Nice To Haves

Supervisory experience in a healthcare environment preferred.
Nursing background preferred.
Certified Professional in Healthcare or quality improvement certification preferred.

Responsibilities

Oversee and manage the functions of the quality improvement program, including HEDIS reporting and other quality improvement activities.
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, including HEDIS reporting.
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.
Manage delegate vendor oversight and corrective action plans as indicated.
Monitor and analyze costs and participate in the preparation of the budget.
Performs other duties as assigned
Complies with all policies and standards