Quality Improvement Coordinator II - Clinical

Centene; United States; On-site; USD 46,000 - 84,000; Full time

Benefits offered by this job

Health insurance

401(k) plan

Stock purchase plan

Tuition reimbursement

Paid time off

Job summary

Centene Corp. is seeking a Quality Improvement professional to coordinate and monitor initiatives from inception to closure across corporate and health plan levels. You will develop and implement QI programs aligned with NCQA and URAC requirements, working closely with leadership and clinical teams in Nevada.

The role requires 3+ years of clinical experience and 1+ year in quality functions, with RN/LPN/LVN licensure and a strong ability to write policies and procedures. CPHQ is preferred.

Qualifications

• Bachelor's degree in Nursing or related medical field required.
• 3+ years of clinical experience and 1+ year in quality function.
• CPHQ preferred and NCQA/URAC proficiency preferred.

Responsibilities

• Coordinate and monitor QI projects from inception to closure.
• Assist with plan to improve NCQA/URAC standards.
• Collect and present data for QI initiatives.
• Support policy development and procedure writing.
• Ensure compliance with applicable laws and standards.

Skills

Quality Improvement

Policy Writing

Data Analysis

Education

Bachelor's degree in Nursing or related medical field

Job description

Position Purpose

Coordinate and monitor quality improvement and organizational projects from inception to closure. Perform duties and functions as required to develop and implement quality improvement programs and initiatives at both the corporate and individual health plan levels according to NCQA, URAC and State requirements.

Key Details

Candidate must live in NV.

Key Responsibilities

• Work with Director of Accreditation to assist with Plan compliance to NCQA/URAC standards.
• Maintain Quality Improvement policies and procedures in compliance with NCQA/URAC requirements and recommend changes/enhancements as indicated.
• Identify best practices, research new processes and recommend overall program enhancements.
• Support the project life cycle including requirements gathering, creation of project plans and schedules, manage resources and facilitate project execution, deployment and closure.
• Assist with collection and presentation of data for identified QI projects; identifying sources, methodology and timeliness for which data is needed.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education & Experience

Bachelor's degree in Nursing or related medical field preferred. 3+ years clinical experience and 1+ years of experience in a quality function. Hands on experience with writing and implementing policies and procedures to support NCQA/URAC or JCAHO accreditation standards preferred. Basic understanding of health insurance business, claims payment procedures, strategies and trends in health care preferred.

License & Certification

RN, LPN or LVN. Current state nursing license and valid driver's license. CPHQ preferred.

Pay Range

$33.71 - $60.67 per hour

About Centene

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.

Benefits

• 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.

Equal Opportunity

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.

Background Check

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act