Senior Manager, Quality Improvement

Centene Corporation

1d•Remote

About The Position

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. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. This is a fully remote position open to candidates residing anywhere within the United States. The ideal candidate will bring deep expertise in HEDIS and quality management, demonstrated leadership experience, and a track record of driving measurable performance and quality improvement initiatives. 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.

Requirements

Bachelor’s degree in Business, Healthcare, or related field.
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.

Nice To Haves

Master's degree preferred.

Responsibilities

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.