Quality Improvement Specialist II
About The Position
Assist with the daily operations and support within the Quality Improvement department including data management, data reporting needs, and project management. This is a remote position, and candidates must reside in Nevada or Arizona. Preferred qualifications include experience with Managed Care Organizations (MCO), Quality Management/Improvement, and HEDIS. At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Requirements
- Associate’s degree in related field or equivalent experience.
- 4+ years of data management experience, with a health insurance organization, in a position with accountability for report generation management or project management.
- Working knowledge of MS Office applications.
Nice To Haves
- Experience with Managed Care Organizations (MCO)
- Experience with Quality Management/Improvement
- Experience with HEDIS
- Experience in quality initiatives (including HEDIS project, study analysis, or NCQA standards)
Responsibilities
- Manage the HEDIS project to include assignment of nurses, adherence to plan timeline, and vendor oversight for timeliness and quality
- Assist in data collection, data entry and generation of reports in support of QI initiatives including but not limited to: access and availability studies, HEDIS abstraction forms, medical records/site reviews, member and physician satisfaction studies
- Analyze data and report writing for committee discussion
- Research and write items for provider newsletters and other educational pieces
- Conduct Interdepartmental inter-rater reliability audits
- Design, run, and manage the data review process to ensure accuracy and integrity of data reports to meet regulatory and operational requirements.
- Implement process improvements to streamline departmental functions
- Assists Director, QI in preparation for audits by regulatory agencies and review organizations
- 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
- a 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
Education Level
Associate degree
