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Senior Manager, Quality Improvement

Role overview

Qualifications

  • Bachelor’s degree in Business, Healthcare, or related field
  • Master's degree preferred
  • 5+ years of quality management experience or equivalent leadership experience
  • Previous experience managing cross functional teams on large scale projects

Responsibilities

  • Provide leadership and direction for continuous quality improvement (QI) initiatives
  • Analyze reports to identify trends and recommend initiatives for improving quality of care
  • Oversee the accreditation process for NCQA Accreditation
  • Manage and implement work tools/processes, reports, and audit tools

Key facts

Other skills

  • Leadership
  • Collaboration
  • Problem Solving

About the company

Centene Corporation logo

Centene Corporation

Health Insurance (Payers)

Centene Corporation provides high-quality healthcare services to members in all 50 states. Since its founding in 1984, Centene has worked to transform the health of communities, one person at a time. Centene is the largest Medicaid managed care organization in the country and provides a portfolio of services to government sponsored healthcare programs. Centene believes that healthcare is best delivered locally. Our local health plans offer a range of health insurance solutions with a focus on providing accessible care to uninsured and under-insured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities. To learn more about career opportunities with Centene, visit: https://jobs.centene.com/

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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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.
 

This is a remote opportunity for candidates residing in the states of Kansas or Iowa.

The ideal candidate will be a data-driven leader with experience/understanding of HEDIS, CAHPS, Star Ratings, gap closure, and provider quality improvement initiatives. They will also be skilled in analyzing data, identifying process improvements, and building strong partnerships with providers and cross-functional teams.

Position Purpose: 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.

  • Oversee accreditation process, specifically as it pertains to National Committee for Quality Assurance (NCQA) Accreditation and compliance with contractual requirements.
  • 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.

Education/Experience:

  • Bachelor’s degree in Business, Healthcare, or related field.
  • Master's degree preferred.
  • 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.

Pay Range: $107,700.00 - $199,300.00 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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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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