Quality Improvement Strategist II — HEDIS/CAHPS, Remote

Centene Management Company LLC; Florida; Hybrid; USD 70,000 - 126,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off & holidays

Flexible work arrangements

Job summary

Centene Management Company LLC in Florida seeks a Quality Improvement Lead to oversee HEDIS/CAHPS/HOS programs, identify trends, and drive performance improvements. You will analyze stakeholder issues, propose solutions, and collaborate with markets and stakeholders to close gaps and sustain high-quality ratings.

The role requires RN or related clinical background, with 4+ years in managed care or health insurance and 2+ years in quality.

Qualifications

• Bachelor’s degree in Nursing or Public Health or related field; Master’s degree preferred.
• 4+ years of clinical experience; managed care or health insurance experience required; 2+ years quality experience preferred.
• RN, LPN, LVN, or LCSW preferred; CPHQ preferred.

Responsibilities

• Identify market trends and oversee quality improvement programs for HEDIS, CAHPS, and/or HOS strategy.
• Assess and propose solutions to drive business value and collaborate with markets & stakeholders.
• Monitor compliance related to state reporting, HHS and HPMS memos for quality ratings.
• Develop resources and tools to foster gap closure and improve member/provider experience.
• Create, maintain and facilitate training for Quality Improvement Health Plan staff.

Skills

Data analysis

Stakeholder collaboration

Problem-solving

Quality improvement

Five Why's / Fishbone analysis

Education

Bachelor’s degree in Nursing or Public Health

Master’s degree preferred

Job description

Centene Management Company LLC in Florida seeks a Quality Improvement Lead to oversee HEDIS/CAHPS/HOS programs, identify trends, and drive performance improvements. You will analyze stakeholder issues, propose solutions, and collaborate with markets and stakeholders to close gaps and sustain high-quality ratings.

The role requires RN or related clinical background, with 4+ years in managed care or health insurance and 2+ years in quality.