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.
Position Purpose: Plans, organizes, and monitors quality related projects to deliver defined requirements and meet company strategic objectives.
- Support enterprise-wide quality initiatives by analyzing and researching potential issues within quality metrics and goals of health plan programs, including the determination of the appropriate target population, health program design, marketing of the program, and data systems; recommend quality improvements to achieve goals, including updates to programs and processes
- Create quality risk assessments and develop processes for health plans to achieve quality metrics
- Utilize Lean 6 Sigma methodologies to identify potential problems and resolutions with enterprise-wide priority metrics
- Collaborate through ad hoc initiative requests and scorecard review and to support initiative development and implementation
- Create, maintain and facilitate quality improvement health plan training
- Performs other duties as assigned
- Complies with all policies and standards
This is remote positions for candidates located in eastern or central time zones. Ideal candidate will have experience improving Medicare Advantage (MA), Dual CMS Stars Quality and Member Experience measures to an overall 4 star or above. Intermediate proficiency with analytical tools (e.g., Excel), ability to create and maintain key presentations, and proficient use of Quality Improvement tools (e.g., Root Cause Analysis). Experience with CMS MA and DSNP technical specifications and solid understanding of CMS MA Star and DSNP ratings and strategies to improve performance.
Education/Experience: Associate’s degree in Nursing, Public Health, or related clinical field, or equivalent experience. 2+ years clinical experience or managed care. Health insurance experience required; 1+ year quality experience preferred.
License/Certification: Registered Nurse, Licensed Practical Nurse, Licensed Vocational Nurse or Licensed Clinical Social Worker preferred; CPHQ preferred
Pay Range: $54,000.00 - $97,100.00 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. Total compensation may also include additional forms of incentives.
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
