Quality Improvement Project Manager

Centene Corporation•St. David's, NV

1d•$70,100 - $126,200•Remote

About The Position

Centene is seeking a Quality Improvement Project Manager to coordinate and monitor quality improvement and organizational projects from inception to closure, with a focus on National Committee for Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Set (HEDIS) preparation. This fully remote role involves providing functional and technical knowledge for NCQA/HEDIS, coordinating work plans, analyzing data, designing and managing data review processes, and implementing interventions to improve health measures. The role also supports corporate compliance, external surveys, and the project life cycle, including requirements gathering, project planning, resource management, and documentation. The Project Manager will coordinate data pulls and manage databases for QI projects, evaluate data capture sources, and maintain detailed project documentation. At Centene, you will connect people to the care they need to live healthier lives. Your work will have a direct impact on individuals, families, and communities, building your skills while making healthcare more accessible and effective. This is work with a purpose, backed by a team committed to improving lives.

Requirements

Bachelor’s degree in Healthcare, Business or equivalent experience.
4+ years of quality improvement or project management experience in managed care.
Advanced knowledge of HEDIS and NCQA.
Proficiency required in Microsoft applications including PowerPoint, Excel and Access.

Nice To Haves

Master's in Public Health or related field preferred.

Responsibilities

Coordinate and monitor quality improvement and organizational projects from inception to closure including National Committee for Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Set (HEDIS) preparation.
Provide functional and technical knowledge for NCQA/HEDIS across all plan departmental staff and deliver educational sessions to internal staff and external constituents as needed.
Coordinate Work Plan, team and resources for HEDIS/Consumer Assessment of Healthcare Providers and Systems (CAHPS) submission to Connector Authority and NCQA.
Analyze data and develop presentations and materials for committee and articles for newsletters and other educational pieces.
Design, run, and manage the data review process to ensure accuracy and integrity of data reports to meet regulatory and operational requirements.
Coordinate and implement interventions to increase HEDIS, CAHPS and designated health measures for the Plan.
Adhere to NCQA standards and work with Corporate Director of Accreditation in maintaining Plan’s NCQA accreditation.
Support the coordination of corporate compliance and external surveys as needed.
Monitor the creation of all project deliverables to ensure adherence to standards including design documents, test plans and operations documentation.
Support the project life cycle including requirements gathering, creation of project plans and schedules, manage resources, support HEDIS audit process, and facilitate project execution, deployment and closure.
Coordinate all data pulls and ongoing data management for HEDIS and QI project management databases for identified QI projects with department staff and corporate contacts.
Evaluate sources for alternative data capture; assess ongoing methodology and results.
Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.