Manager, Quality Improvement

Centene Corporation•Remote-AR, AR

3d•$87,700 - $157,800•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 oversees and manages the functions of the quality improvement program, providing support to staff and communicating with departments and staff to facilitate daily quality improvement (QI) functions.

Requirements

Bachelor’s degree in related field or equivalent experience.
3+ years clinical, quality management or healthcare related experience.
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.

Nice To Haves

Experience with managed care, Medicare STARS, HEDIS, and quality improvement initiatives strongly preferred.
Experience with provider engagement, gap closure strategies, electronic data submissions, supplemental data sources, flat files, and hybrid review processes.

Responsibilities

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.