Hybrid Quality Improvement Coordinator II

Centene Corp.; Arizona; Hybrid; USD 46,000 - 84,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Flexible schedules

Job summary

Centene Corp. in Arizona seeks a healthcare quality professional to conduct on-site reviews of delegated entities, physician offices, and clinics.

You will investigate complaints, audit medical records, and analyze data for quality improvements while coordinating with community resources for clinical initiatives. The role requires a nursing degree and 3+ years of healthcare quality experience, with 2+ years in quality function.

Qualifications

• Bachelor's degree in Nursing required or preferred.
• 3+ years of clinical, quality improvement or healthcare experience.
• 2+ years of experience in quality function in a healthcare setting.

Responsibilities

• Perform on-site quality reviews of delegated entities, physician offices and clinics, resolve issues and generate written summaries.
• Document, investigate and resolve formal and informal complaints, risk management and sentinel events related to quality of care.
• Audit medical records, review administrative claims and analyze data for quality improvement studies.
• Serve as liaison between community resources/agencies and Centene for clinical initiatives and guidance.
• Schedule and chair meetings with delegated entities per contract and gather data for utilization and quality reports.
• Develop and implement Corrective Action Plans and recommend changes to Quality Improvement policies and procedures.
• Identify best practices, research new processes and suggest program enhancements and coordinate QIC activities.

Skills

Clinical experience

Quality improvement

Healthcare compliance

Education

Bachelor's degree in Nursing

Job description

Centene Corp. in Arizona seeks a healthcare quality professional to conduct on-site reviews of delegated entities, physician offices, and clinics.

You will investigate complaints, audit medical records, and analyze data for quality improvements while coordinating with community resources for clinical initiatives. The role requires a nursing degree and 3+ years of healthcare quality experience, with 2+ years in quality function.