Centene Corporation-posted 8 days ago
Full-time • Mid Level
Remote • Town of Chazy, VA
5,001-10,000 employees

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. NOTE: This is a remote, work-from-home role with up to 10% travel to our Columbus office for mandatory on-site meetings, projects and trainings. Preference will be given to applicants who (1) reside in Ohio or its bordering states, and have a (2) combination of experience in the following areas: HEDIS, managed care, quality, process improvement/ project management (such as lean, CPHQ, IHI training). Additional Details: • Department: MED-Quality Improvement • Business Unit: Buckeye Community Health Plan • Schedule: Monday through Friday, 8am-5pm eastern Position Purpose: Plans, organizes, and monitors quality related projects to deliver defined requirements and meet company strategic objectives. Support enterprise-wide quality initiatives by analyzing and researching potential issues within quality metrics and goals of health plan programs, including the determination of the appropriate target population, health program design, marketing of the program, and data systems; recommend quality improvements to achieve goals, including updates to programs and processes Create quality risk assessments and develop processes for health plans to achieve quality metrics Utilize Lean 6 Sigma methodologies to identify potential problems and resolutions with enterprise-wide priority metrics Collaborate through ad hoc initiative requests and scorecard review and to support initiative development and implementation Create, maintain and facilitate quality improvement health plan training Performs other duties as assigned Complies with all policies and standards

  • Plans, organizes, and monitors quality related projects to deliver defined requirements and meet company strategic objectives.
  • Support enterprise-wide quality initiatives by analyzing and researching potential issues within quality metrics and goals of health plan programs, including the determination of the appropriate target population, health program design, marketing of the program, and data systems; recommend quality improvements to achieve goals, including updates to programs and processes
  • Create quality risk assessments and develop processes for health plans to achieve quality metrics
  • Utilize Lean 6 Sigma methodologies to identify potential problems and resolutions with enterprise-wide priority metrics
  • Collaborate through ad hoc initiative requests and scorecard review and to support initiative development and implementation
  • Create, maintain and facilitate quality improvement health plan training
  • Performs other duties as assigned
  • Complies with all policies and standards
  • Associate’s degree in Nursing, Public Health, or related clinical field, or equivalent experience.
  • 2+ years clinical experience or managed care.health insurance experience required
  • Residence in Ohio or its bordering states needed for this role.
  • 1+ year quality experience preferred.
  • Registered Nurse, Licensed Practical Nurse, Licensed Vocational Nurse or Licensed Clinical Social Worker preferred
  • CPHQ preferred
  • Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.
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