Quality Program Development Manager

Home State Health; Iowa; Híbrido; USD 70.000 - 126.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work arrangements

Descripción de la vacante

Centene in the United States seeks a Program Development Manager to lead cross-functional initiatives across Quality, Health Services and Operations, developing standards, policies and decision support systems to drive ongoing improvements.

You will guide program design, manage performance improvement projects, and partner with leaders to deliver process improvements that enhance patient care and operational efficiency.

Formación

• Bachelor's degree or equivalent in a related field.
• 5+ years of direct program development, management experience, preferably in healthcare.
• 3+ years in managed care and quality program areas.
• 2+ years designing and implementing enterprise quality programs (STARS, CAHPS, HEDIS).

Responsabilidades

• Oversees development and implementation of programs aligned with organizational initiatives.
• Designs and facilitates development of programs, workflows, and integration efforts with regulatory and quality requirements.
• Leads projects including plan development, root cause analysis, and progress monitoring.
• Coordinates performance improvement projects, including topic selection and final submission.
• Partners with leaders to determine data needs and develops tools/reports as needed.
• Supports initiatives to improve patient quality of care and interoperability of services.
• Performs other duties as assigned.

Conocimientos

Program development

Project management

Quality Improvement

Healthcare operations

Stakeholder engagement

Data analysis

Educación

Bachelor's degree in a related field

Master's degree in related field (MBA, MHA, MPH, MSN) — preferred

5+ years of direct program development/project management experience

3+ years of managed care/utilization management experience

2+ years experience in STARS/CAHPS/HEDIS quality programs

Six Sigma Certification

Lean Certification

CPHQ Certification

Herramientas

Six Sigma

Lean

CPHQ

Descripción del empleo

Position Purpose

Functions as a program development manager in collaboration with Quality, Health Services and Operations business owners or cross‑functional work groups in the development and implementation of efficient and effective standards, policy and procedures, work flows, and decision support systems to support ongoing improvements of clinical and administrative operations.

Responsibilities

• Oversees the creation and implementation of programs relevant to the organization\'s strategic initiatives involving Health Services, clinical and operational quality administration.
• Designs and facilitates the development of various programs/systems, work flows, and integration efforts in alignment with Corporate, market, contractual, regulatory and quality requirements.
• Acts as the content and technical subject matter expert to the operation managers and directors for key project initiatives including the development of detailed work plans, facilitating route cause analysis, identifying and socializing process enhancements, setting deadlines, assigning responsibilities, and monitoring/summarizing project progress.
• Leads state required Performance Improvement Projects (PIP) including topic selection, root cause analysis, implementation, and final submission.
• Conducts needs assessments and identification to ensure the program teams and other external stakeholders receive information in a timely manner.
• Partners with leaders and members of the Quality Analytics and Improvement Teams and determines data needs as well as assists in designing tools and reports as necessary
• Partners with clinical and operations staff with consulting and analysis services to support initiatives intended to achieve breakthrough or incremental process improvement in patient quality of care
• Conducts other responsibilities as needed.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education and Experience

• Required A Bachelor's Degree in a related field
• Required or equivalent work experience Business, HC Management, or Nursing:
• Preferred A Master's Degree in a related field Business or HC Management (MBA, MHA, MPH, MSN):
• Candidate Experience: Required 5+ years of experience in direct program development, program management, and/or project management, preferably in a healthcare environment
• Required 3+ years of experience in managed care, plus utilization management, care coordination, disease management, Medicare, Medicaid, DSNP, dual eligibles, PCMH
• Required 2+ years of experience in design, develop and implement STARS, CAHPS, HEDIS and other enterprise quality related programs across a variety of settings including: defining the eligible population, service mix, delivery system configuration and financing; integration of behavioral, clinical, social, and community health care for members with multiple chronic conditions; working with multiple market leaders to coordinate consistent quality initiatives; conducting assessments, contractual reviews, and business plans for new quality improvement, including internally sourced or vendor sourced quality programs, and/or the integration of innovative approaches to defined programs to improve quality ratings company wide.
• Licenses and Certifications : A license in one of the following is preferred
• Six Sigma Certification
• Lean Certification
• Certified Professional in Healthcare Quality (CPHQ)
• Pay Range: $70,100.00 - $126,200.00 per year

Benefits

• 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

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.

Centene offers a comprehensive benefits package including: 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.

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