Quality Improvement Coordinator (HEDIS)

Centene Corporation

1d•$27 - $49•Remote

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: Analyze, develop, implement and monitor clinical quality improvement initiatives to achieve healthy outcomes. Perform duties and functions to comply with quality improvement programs according to state requirements. Support Quality Assurance Performance Improvement work plan/initiatives. Schedule and assist with committee and sub-committee preparation. Assist in investigation and resolution of member quality of care complaints. Audit medical records and monitor performance measures for health care risk management, sentinel events and trends. For PA H&W only: Responsible for overseeing reporting and outcome measurement and HEDIS data collection, serving as point person between the Department and the Department’s EQR contractor. Performs other duties as assigned Complies with all policies and standards This is a fully remote role seeking an RN or LPN with experience in quality improvement, specifically identifying and closing HEDIS gaps in care.

Requirements

Bachelor’s degree in nursing preferred.
2+ years clinical, quality management or healthcare related experience.
At least one year experience in quality function in a healthcare setting.
LPN, LVN, RN, PA, or LCSW license preferred.

Nice To Haves

Utilization management certification preferred.
Certified Professional in Healthcare Quality preferred.

Responsibilities

Analyze, develop, implement and monitor clinical quality improvement initiatives to achieve healthy outcomes.
Perform duties and functions to comply with quality improvement programs according to state requirements.
Support Quality Assurance Performance Improvement work plan/initiatives.
Schedule and assist with committee and sub-committee preparation.
Assist in investigation and resolution of member quality of care complaints.
Audit medical records and monitor performance measures for health care risk management, sentinel events and trends.
Responsible for overseeing reporting and outcome measurement and HEDIS data collection, serving as point person between the Department and the Department’s EQR contractor.
Performs other duties as assigned
Complies with all policies and standards