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Manager, Operations, HEDIS Engine & Operational Technologies

Roles & Responsibilities

  • Bachelor's degree in Business Administration, related field, or equivalent experience
  • 4+ years of experience in operational business processes or data analysis, preferably in the managed care or insurance industry
  • Practical experience implementing continuous improvement via Six Sigma or Total Quality Management (TQM)
  • Experience working within a matrix environment and strong HEDIS operations experience highly preferred

Requirements:

  • Oversee operations and business strategy utilizing cross-functional departments; serve as the product owner for the HEDIS engine and operational technologies, overseeing hybrid project builds, measure catalog support, and day-to-day execution
  • Develop and manage methodologies for tracking, identifying and solving issues; interpret and present program results and insights; develop data-driven analysis for clients
  • Perform data analysis from diverse data sources to evolve metrics measuring effectiveness and ROI of current and new product activity; collaborate with staff to identify internal and external customers and their expectations; initiate process changes to increase quality, decrease costs, and improve staff, provider, and member satisfaction
  • Facilitate and support operations staff in planning, achievement, and tracking of the organization's key strategic initiatives to positively impact the organizational scorecard; serve as an internal resource/advisor on improvement activities; explore new approaches to work processes using quality improvement techniques; travel up to 25%

Job description

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.
 

*Applicants for this job have the flexibility to work remote from home anywhere in the United States.

Position Purpose: Oversee operations, and business strategy utilizing cross-functional departments to meet strategic objectives. This Manager serves as the product owner for the HEDIS engine and operational technologies, overseeing hybrid project builds, measure catalog support, and day-to-day execution within related platforms.

  • Develop and manage methodologies for tracking, identifying and problem-solving issues, interpreting and presenting program results and insights, and developing data-driven analysis approach for clients
  • Perform data analysis from a variety of data sources to evolve the metrics used to measure effectiveness and return on investment of all current and new product activity
  • Collaborate with staff to identify internal and external customers and their expectations, initiate process changes to increase quality, decrease costs and improve staff, provider and member satisfaction
  • Facilitate and support operations staff in the planning, achievement, and tracking of the organizations key strategic initiatives to create a positive impact on organizational scorecard
  • Serve as an internal resource and advisor on improvement activities
  • Explore new approaches to work processes by utilizing quality improvement techniques to eliminate waste and re-work
  • Able to travel up to 25%

Education/Experience: Bachelor’s degree Business Administration, related field, or equivalent experience. 4+ years experience in operational business processes or data analysis, preferably in the managed care or insurance industry. Practical experience implementing continuous improvement via Six Sigma or Total Quality Management (TQM) is desirable. Experience working within a matrix environment preferred. Strong HEDIS operations experience highly preferred.

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.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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