Centene Corp

Director, Quality Improvement

Centene Corp • $118K — $219K *
US-AnywhereRemote in Missouri, US
Hospitals & Medical Centers
5 - 7 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Bachelor's Degree in Nursing or related field; Master's preferred
  • 7+ years of experience in quality management or healthcare operations
  • Experience with HEDIS operations and quality strategies preferred
  • Certification as a Professional in Health Care Quality is a plus
  • Strong analytical and process improvement skills

Responsibilities

  • Lead process improvement activities for efficient workflows
  • Collaborate on NCQA Accreditation and HEDIS performance
  • Drive quality improvement for risk adjustment processes
  • Work with Medicare STARS team to enhance ratings
  • Oversee implementation of provider satisfaction action plans
  • Research and integrate best practices in operations
  • Present improvement results and performance measures to senior management

Benefits

  • Comprehensive health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off and holidays
  • Flexible work schedule options including remote work
Full Job Description
This is a remote opportunity supporting enterprise-wide quality strategy initiatives throughout the year. Experience with HEDIS operations and quality strategy initiatives is highly preferred.

Position Purpose:
Lead and direct process improvement activities that provide more efficient and streamlined workflow.

  • Responsible for leading and collaborating with others on National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance
  • Responsible for quality improvement aspects of risk adjustment processes for all products
  • Collaborate with Medicare STARS team to improve overall STARS ratings for Medicare products (including HEDIS, CAHPS, HOS)
  • Oversee provider satisfaction surveys and implement action plans for improvements
  • Research and incorporate best practices into operations
  • Organize and control activities, methods, and procedures to achieve business objectives
  • Review and implement new technological tools and processes and fosters team concept with internal and external constituencies
  • Present results of improvement efforts and ongoing performance measures to senior management
  • Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines
  • For Coordinated Care – Washington – Director, Quality Improvement & Health Equity position only:
  • Oversee Coordinated Care's Cultural Competency Program, including its Cultural Competency Plan focused on Culturally and Linguistically Appropriate Services (CLAS)
  • Lead Coordinated Care’s Health Disparities efforts, including those focused on justice involved individual members
  • Collaborate with State, County, and local agencies to promote services that improve health outcomes, decrease health disparities and reduce the cost of care.
  • Work closely with State, County and local agencies, community stakeholders and communities to monitor the application of all standards
  • Promote an environment of cultural competence throughout the health plan through identification and implementation of culturally-inclusive best practices and innovations, such as the development of provider trainings to improve cultural awareness and competency within the provider network
  • Oversee the assessment of cultural diversity of the provider network to identify resources and gaps, including needs analysis for non-traditional providers (traditional healers, religious and spiritual resources, natural support systems, etc.) and develops recommendations for credentialing and network development activities.
  • Monitor and evaluate provider practices through KPIs within health equity dashboards to assess and improve the cultural competence of delivered services by addressing care gaps and aligning interventions to resolve.
  • Oversee the population specific activities (such as training, awareness through the media, and partnering with various external equity stakeholders), including cultural treatment teams and other cultural community support system activities.
  • Oversee the comprehensive, outcomes-based Cultural Competency Plan that is aligned with CLAS standards and national and regional priorities/initiatives.
  • The plan also incorporates data-driven assessments of culturally competent performance, and defines a strategy for the continual provision, monitoring and improvement of culturally competent performance.
  • Manage outreach budget for Cultural Competency programs and sponsorships.
  • Performs other duties as assigned.
  • Complies with all policies and standards.


Education/Experience:

  • Bachelor's Degree Nursing, other related field or equivalent experience required
  • Master's Degree preferred
  • 7+ years of quality management, quality improvement or healthcare operations experience required
  • Certified Professional in Health Care Quality preferred:

Pay Range: $118,400.00 - $219,000.00 per year

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.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

About Centene Corp

Centene Corporation is a managed healthcare enterprise at the forefront of innovation and growth for government-sponsored and commercial healthcare, providing access to fully integrated, high-quality, and cost-effective services that help people lead healthier lives. The company’s local approach addresses the needs of under-insured and uninsured individuals who often lack the resources required to sustain optimal health and wellness. Centene began as a single health plan in Milwaukee, Wisconsin in 1984. After an initial period of growth, Michael Neidorff joined as President and Chief Executive Officer (CEO) in 1996, moving Centene’s headquarters to St. Louis, Missouri, where it still resides today. In the decades since its humble beginnings, Centene has transformed into a publicly-traded Fortune 500 company serving communities across the United States. In fact, Centene provides coverage in all 50 U.S. states. More than 26 million Americans rely on Centene to access a wide range of insurance solutions, including Medicaid, Medicare, TRICARE, correctional, and behavioral health services. Centene prioritizes the development of technology that addresses systemic conditions impacting the whole health needs of underserved populations. As technology plays an increasingly critical role in diagnosing, managing, and treating disease, Centene understands that it enables better health outcomes for members, lessening the burden for providers, and allowing more automation and efficiency for business operations. As a steward of a significant set of data and insights, Centene leverages this data to not only shape but lead the digital transformation of healthcare and improve the patient-provider experience. Centene’s current CEO, Sarah London, and her team are leading the charge in this new age. Sarah London worked within Centene’s Technology Innovation and Modernization division, spearheading the company’s enterprise-wide technology strategy. Now leading Centene, her focus is on building the next generation of products and services and establishing Centene’s long-term growth and value creation. Although Centene has grown into the No. 1 insurer in the U.S. Health Insurance Marketplace, it has never lost its focus on the individual or its passion for community health. Remaining connected to the individuals and families that need care most is central to Centene’s commitment to shaping a better world of healthcare for the communities it serves. Centene also remains connected to the needs of its employees, who make Centene what it is. Through its commitment to diversity, equity, and inclusion practices, Centene promotes a safe and inviting environment above all. Because of Centene’s commitment to excellence and progression in the healthcare industry, it has been recognized as a Top Organization for Diversity by Modern Healthcare magazine, a Leading Disability Employer by the National Organization on Disability, a Best Place to Work for LGBTQ Equality by The Human Rights Campaign Foundation, and a global leader by Bloomberg’s Gender-Equality Index, among many other recognitions. Centene was also named a Top 50 Company for Diversity by DiversityInc and a Top Veteran-Friendly Company by U.S. Veterans Magazine. It has also been listed on FORTUNE® magazine's list of the World's Most Admired Companies for several consecutive years.

Centene Corp Careers

Join the dynamic team at Centene Corp, a leader in the healthcare industry, where your career growth and development are prioritized. At Centene Corp, we offer a range of job opportunities that allow you to make a significant impact on our community and beyond.

Explore a World of Opportunities

Discover the diverse career paths available at Centene Corp, from healthcare services to innovative program development. Our job opportunities span various professional fields, offering positions that cater to your unique skills and ambitions. Whether you're looking for an entry-level role or a senior leadership position, Centene Corp is committed to hiring top talent and fostering a culture of excellence.

Innovation and Leadership at Centene Corp

At Centene Corp, innovation and leadership go hand in hand. We empower our team members to lead with confidence and creativity, driving the company forward through strategic innovation and robust leadership. Our leadership programs are designed to cultivate your skills, helping you to thrive as a professional and make meaningful contributions to our company and the communities we serve.

Internships and Early Career Programs

Kickstart your career with Centene Corp through our internship and early career programs. These opportunities provide hands-on experience and a glimpse into the dynamic world of healthcare management. Internships at Centene Corp are a stepping stone to full-time employment, offering invaluable networking opportunities, mentorship, and the chance to develop your resume and interview skills in a real-world setting.

Commitment to Diversity and Inclusive Culture

Centene Corp is dedicated to maintaining a diverse and inclusive work environment. We believe that diversity fuels innovation and enhances our team's performance. Our diversity training ensures that all team members appreciate and leverage the broad range of experiences and perspectives that each individual brings to the company.

Benefits and Employee Growth

We value our employees' well-being and career aspirations. Centene Corp offers competitive benefits, including health insurance, retirement plans, and professional development programs. Our commitment to your growth is reflected in our continuous learning initiatives and performance management processes that help you achieve your career goals.

Join Our Team

Are you ready to advance your career at Centene Corp? Explore our current job openings and find the position that best matches your skills and interests. We are looking for passionate, curious, and solution-driven team players who are ready to make a difference.

Stay Connected with Centene Careers

Keep up to date with the latest career tips, insider perspectives, and industry-leading insights—all from the people who work at Centene Corp. Personalize your subscription to receive job alerts, latest news, and insider tips tailored to your preferences. Discover the exciting and rewarding opportunities that await you at Centene Corp.

SEARCH CENTENE JOBS

Centene Corp is not just a company—it's a place where you can shape your future and impact the lives of millions. Join us in our mission to transform the health of the community, one person at a time.
Learn more about Centene Corp
Size
72,500 employees
Market Cap
$46.5 billion
Industry
Healthcare
Net Income
$1.8 billion
Founded
1984
5 Year Trend
+25.4%
Revenue
$111.1 billion
NASDAQ
CNC
* Ladders Estimates

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