Behavioral Health HEDIS & P4P Improvement Lead

Centene Management Company LLC; Missouri; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements

Job summary

Centene Management Company LLC seeks a Behavioral Health HEDIS Improvement Supervisor to supervise interventions that drive HEDIS and Pay-for-Performance outcomes. You will partner with health plans and regional clinical leadership to identify and implement strategies that raise behavioral health metrics.

You will coordinate with quality improvement teams, present ROI analyses, monitor initiatives, and guide clinical staff to sustain improvements. A flexible work approach is supported.

Qualifications

• Bachelor’s degree in nursing, related field, or equivalent experience.
• 3+ years of experience in case and/or utilization management in behavioral/physical health care.
• Knowledge of HEDIS & performance measures with experience implementing interventions.

Responsibilities

• Develop and implement strategies with clinical staff to improve HEDIS/P4P measures.
• Prepare and present ROI for initiatives requiring funding.
• Liaise with QA, health plans and departments; collect input and report outcomes.
• Monitor P4P/HEDIS initiatives and ensure education and interventions reach members.
• Analyze data to identify trends and opportunities for quality improvement.
• Performs other duties as assigned.
• Complies with policies and standards.

Skills

Supervisory experience

HEDIS knowledge

Data analysis

Education

Bachelor’s degree in nursing or related field

Job description

Centene Management Company LLC seeks a Behavioral Health HEDIS Improvement Supervisor to supervise interventions that drive HEDIS and Pay-for-Performance outcomes. You will partner with health plans and regional clinical leadership to identify and implement strategies that raise behavioral health metrics.

You will coordinate with quality improvement teams, present ROI analyses, monitor initiatives, and guide clinical staff to sustain improvements. A flexible work approach is supported.