Quality Program Strategist

Centene Management Company•Buckeye, AZ

9d•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. 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

Requirements

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.

Nice To Haves

1+ year quality experience preferred.
Registered Nurse, Licensed Practical Nurse, Licensed Vocational Nurse or Licensed Clinical Social Worker preferred
CPHQ preferred

Responsibilities

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