Manager, Quality Improvement

Centene Corporation•Remote-KS, IA

3d•$87,700 - $157,800•Remote

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 fully remote, offering the flexibility to work from home. Occasional travel may be required, typically no more than 3–4 times per year, for team onsite meetings, training events, or corporate gatherings. The purpose of this role is to oversee and manage the functions of the quality improvement program, providing support to staff and communicating with departments and staff to facilitate daily quality improvement (QI) functions. This includes reviewing and analyzing reports, records, and directives, and conferring with staff to obtain data such as new projects, status of work in progress, and problems encountered, required for planning work function activities. The role also involves verifying data to be submitted in accordance with government program requirements and ensuring compliance with state, federal, and certification requirements. Preparing reports and records on work function activities for management, overseeing the review and analysis of reports, and evaluating 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 are key responsibilities. Additionally, the role requires collaborating with appropriate departments to document, investigate, and resolve formal or informal complaints and appeals in accordance with Company and State policies, procedures, and requirements, and monitoring and analyzing costs and participating in the preparation of the budget.

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.

Nice To Haves

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.

Responsibilities

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.