Centene Corp

Manager, Performance Quality Improvement

Centene Corp$87K — $157K *
US-Anywhere
+ 2 other locationsRemote
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in healthcare, business, or related field or equivalent experience
  • 4+ years of quality improvement data and outcome analysis experience in health care
  • Experience in managed care with knowledge of HEDIS and NCQA preferred
  • Strong knowledge of NCQA accreditation standards and HEDIS measures
  • Certified Professional in Healthcare Quality (CPHQ) preferred

Responsibilities

  • Oversee quality improvement related activities and staff to enhance clinical quality performance measures
  • Analyze data for developing intervention strategies to improve health outcomes
  • Develop and implement performance improvement projects
  • Prepare and present reports on quality programs to internal and external stakeholders
  • Coordinate data management for HEDIS and quality improvement project databases
  • Oversee medical record management for HEDIS reporting and year-round abstraction
  • Drive HEDIS and 5 Star project improvement activities

Benefits

  • Comprehensive health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off and holidays
  • Flexible work arrangements including fully remote options
Full Job Description

We are seeking an experienced quality manager to provide strategic oversight of HEDIS Operations and Quality Improvement initiatives, driving excellence in NCQA and HEDIS performance across the organization. This role will lead hybrid season planning and execution, ensure audit readiness and regulatory reporting compliance, oversee vendor management and chart retrieval operations, and implement data-driven strategies to improve quality measure performance and health outcomes. The ideal candidate brings expertise in managed care quality programs, cross-functional leadership, and continuous process improvement to support organizational quality and regulatory goals.

Position Purpose: Oversee and manage the functions of the quality improvement program from inception to closure, including National Committee for Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Sets (HEDIS) performance improvement projects.

  • Oversee quality improvement related activities and staff to improve clinical quality performance measures.
  • Analyze data to develop intervention strategies to improve outcomes.
  • Develop and implement performance improvement projects.
  • Develop, prepare, and present reports on quality programs and issues to both internal and external stakeholders.
  • Provide data analysis and support for QM projects (i.e. outcome studies, QI projects).
  • Coordinate ongoing data management for HEDIS and QI project management databases. Evaluate sources for alternative data capture, assess ongoing methodology and results.
  • Develop, implement and monitor data review process to ensure accuracy and integrity of data reports to meet regulatory and operational requirements.
  • Oversees the medical record management process for HEDIS reporting, including all processes involved with year round abstraction and MRR.
  • Oversee HEDIS team including workflow, tracking, reporting and improvement of processes related to member engagement and MRR efforts.
  • Develops tracking, tools, and programs to support HEDIS staff to drive HEDIS and 5 Star project improvement activities. Ensures MRR efforts meet NCQA HEDIS audit standards.
  • Performs other duties as assigned.
  • Complies with all policies and standards.

Education/Experience: Bachelor's degree in healthcare, business, or related field or equivalent experience. 4+ years of quality improvement data and outcome analysis experience in health care. Experience in managed care with knowledge of HEDIS and NCQA preferred.

Preferred Experience

  • Experience leading HEDIS Operations within a health plan, managed care, or healthcare quality environment.
  • Strong knowledge of NCQA accreditation standards, HEDIS measures, hybrid methodology, and audit requirements.
  • Demonstrated success managing hybrid reviews, chart retrieval operations, and vendor relationships.
  • Experience with regulatory reporting, quality improvement programs, and performance measurement initiatives.
  • Proven ability to lead large-scale operational projects and collaborate effectively across clinical, quality, analytics, and operations teams.



License/Certificates: Certified Professional in Healthcare Quality (CPHQ) preferred.

Work Location: This position is fully remote, offering the flexibility to work from home. Occasional travel may be required, typically no more than 3–4 times per year, for team onsite meetings, training events, or corporate gatherings.

Pay Range: $87,700.00 - $157,800.00 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.

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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
Net Income
$1.8 billion
Founded
1984
5 Year Trend
+25.4%
Revenue
$111.1 billion
NASDAQ

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