Quality Improvement Specialist (non Clinical)

Position Purpose: Support the development and maintenance of quality improvement related projects and reporting. Respond to quality improvement inquiries.

Key Details: Candidates residing in California are strongly preferred and all candidates must be available to work Pacific Time (PST) business hours. Certification as a Certified Professional in Health Care Quality (CPHQ) is preferred. Ideal candidates will have experience with HEDIS, audit processes, and medical records review.

• Heavy chart monitoring and auditing of medical records
• Monitor the production of quality results reporting; analyze, track and trend the reporting results and report them to management
• Formulate and prepare ad-hoc and additional reporting requirements
• Recommend, develop, and implement quality improvement plans with management
• Train providers and staff in methodologies and tools of continuous quality improvement
• Prepare for and participate in meetings with State agencies, providers, and stakeholders
• Perform audits on to meet state and internal requirements
• Performs other duties as assigned
• Complies with all policies and standards

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.
 

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