Senior Manager, Quality Improvement, HEDIS Audit

Centene Corporation•Remote-TX, TX

2d•$107,700 - $199,300•Remote

About The Position

Provide leadership and direction for continuous quality improvement (QI) initiatives to improve efficiency, processes and demonstrate improved quality. Provide and analyze reports to identify trends, opportunities and recommend initiatives aimed at improving quality of care and services provided by the organization. This role will lead national HEDIS audit and submission activities, including Measure Specifics, HOQ, IDSS, PLD, XML, benchmarking, and final submission. 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

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.
Bachelor’s degree in Business, Healthcare, or related field.
5+ years of quality management experience or equivalent leadership experience.
Previous experience as lead in functional area, managing cross functional teams on large scale projects or supervisory experience which includes hiring, training, assigning work and managing the performance of staff.

Nice To Haves

Master's degree preferred.
Strong HEDIS audit and submission experience highly preferred.

Responsibilities

Responsible for overall coordination of company-wide quality assessment and improvement activities.
Oversee and coordinate with Corporate on annual file audits and other quality related initiatives to include those of a contractual nature.
Manage and implement appropriate work tools/processes, reports and audit tools to ensure control of key processes and program characteristics.
Recommend quality improvement opportunities based on findings and participation in developing and implementing solutions to management and the Quality Improvement Committee (QIC) and other committees, as appropriate.
Provide feedback to rectify errors and to prevent further inconsistencies.
Oversee monthly and quarterly reports and data to identify trends, opportunities for improvement and interventions.
Responsible for policies, operating procedures, and aligning goals in compliance with internal and external guidelines.
Lead national HEDIS audit and submission activities, including Measure Specifics, HOQ, IDSS, PLD, XML, benchmarking, and final submission.