Quality Improvement Project Manager

Centene Corp.; Northern (KY); Hybrid; USD 70,000 - 126,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K/Stock plan

Tuition reimbursement

Paid time off

Job summary

Centene Corp. is seeking a remote Quality Improvement/Project Management professional to oversee NCQA/HEDIS initiatives. The role involves coordinating work plans, teams, and data for submissions, and delivering training to internal staff and external partners.

The ideal candidate has a Bachelor’s in Healthcare or Business along with 4+ years in quality improvement in managed care, and a Master’s in Public Health is preferred. Proficiency in PowerPoint, Excel and Access is required.

Qualifications

• Bachelor’s degree in Healthcare, Business or equivalent experience.
• Master’s in Public Health or related field preferred.
• 4+ years of quality improvement or project management experience in managed care with advanced knowledge of HEDIS and NCQA.
• Proficiency in Microsoft applications including PowerPoint, Excel and Access.

Responsibilities

• Coordinate and monitor quality improvement and organizational projects from inception to closure.
• Provide knowledge for NCQA/HEDIS across plan staff and deliver educational sessions.
• Coordinate work plans, teams and resources for HEDIS/CAHPS submission and data management.
• Analyze data and develop presentations and materials for committees and newsletters.
• Maintain project documentation including meeting notes, action items and risk plans.

Skills

Quality improvement

Project management

NCQA knowledge

Microsoft Office proficiency

Education

Bachelor’s degree in Healthcare or Business

Master’s degree in Public Health or related field

Tools

PowerPoint

Excel

Access

Job description

***NOTE: This is a fully remote role***

Position Purpose

Coordinate and monitor quality improvement and organizational projects from inception to closure including National Committee for Quality Assurance (NCQA) and Healthcare Effectiveness Data and Information Set (HEDIS) preparation. Provide functional and technical knowledge for NCQA/HEDIS across all plan departmental staff and deliver educational sessions to internal staff and external constituents as needed. Coordinate Work Plan, team and resources for HEDIS/Consumer Assessment of Healthcare Providers and Systems (CAHPS) submission to Connector Authority and NCQA. Analyze data and develop presentations and materials for committee and articles for newsletters and other educational pieces. Design, run, and manage the data review process to ensure accuracy and integrity of data reports to meet regulatory and operational requirements. Coordinate and implement interventions to increase HEDIS, CAHPS and designated health measures for the Plan. Adhere to NCQA standards and work with Corporate Director of Accreditation in maintaining Plan’s NCQA accreditation. Support the coordination of corporate compliance and external surveys as needed. Monitor the creation of all project deliverables to ensure adherence to standards including design documents, test plans and operations documentation. Support the project life cycle including requirements gathering, creation of project plans and schedules, manage resources, support HEDIS audit process, and facilitate project execution, deployment and closure. Coordinate all data pulls and ongoing data management for HEDIS and QI project management databases for identified QI projects with department staff and corporate contacts. Evaluate sources for alternative data capture; assess ongoing methodology and results. Maintain detailed project documentation including meeting minutes, action items, issues lists and risk management plans.

Education and Experience

Bachelor’s degree in Healthcare, Business or equivalent experience. Master's in Public Health or related field preferred. 4+ years of quality improvement or project management experience in managed care with advanced knowledge of HEDIS and NCQA. Proficiency required in Microsoft applications including PowerPoint, Excel and Access.

Pay Range

$70,100.00 - $126,200.00 per year

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

Centene offers a comprehensive benefits package including:

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• 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 Statement

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.