Quality Improvement Specialist (HEDIS)
Centene Corporation•Remote-OK, OK
•$56,200 - $101,000•Hybrid
About The Position
Centene is seeking a Quality Improvement Specialist (HEDIS) to support the development and maintenance of quality improvement related projects specific to HEDIS Hybrid Operations. This role is crucial for supporting health plans in the clinical aspect of medical record review. The company is transforming the health of communities and offers competitive benefits and workplace flexibility.
Requirements
- Bachelor’s degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) or equivalent experience in related healthcare experience.
- Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.
Nice To Haves
- Valid state clinical license preferred (i.e.- LPN, RN, etc.)
Responsibilities
- Train providers, health plans and staff in methodologies and tools of continuous quality improvement and HEDIS abstraction and over-read processes
- Provide clinical support to the medical record abstraction, over-read and audit processes
- Monitor performance on established contractual quality indicators.
- Analyze, track and trend results
- Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders
- Recommend, develop, and implement quality performance improvement plans (PIPs) with management utilizing the PDSA model.
- Monitor and report PIPs progress through closure.
- Performs other duties as assigned
- Complies with all policies and standards
Benefits
- competitive pay
- health insurance
- 401K
- stock purchase plans
- tuition reimbursement
- paid time off
- holidays
- flexible approach to work with remote, hybrid, field or office work schedules
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
