Remote Accreditation & HEDIS Specialist

Centene Corporation; Georgia; Hybrid; USD 56,000 - 101,000; Full time

Job summary

Centene Corporation is seeking a Quality Improvement professional to lead performance improvement initiatives focused on clinical quality and measure outcomes. The role supports NCQA/HEDIS activities, accreditation readiness, and delegated vendor coordination.

The position emphasizes policy development, training, and audits to ensure compliance with state and federal requirements. Remote work within the continental United States is supported.

Qualifications

• Bachelor’s degree in Business or a related field, or equivalent experience.
• At least 3 years of related quality improvement experience.
• Experience with NCQA/HEDIS preferred.

Responsibilities

• Develop and coordinate delegation oversight mechanisms and act as liaison for the Plan with Corporate Delegation Oversight.
• Develop and maintain accreditation readiness schedule.
• Create policy and procedures to support accreditation activities.
• Conduct training and education programs for Plan, provider network, delegated vendors to support NCQA and HEDIS activities.
• Develop QI, NCQA and HEDIS projects with delegated vendors to support accreditation maintenance and HEDIS reporting.
• Coordinate assigned NCQA and HEDIS work plan activities.
• Assist with delegation oversight audits and coordinate corrective action plans to ensure compliance with all state, federal, contract and accreditation requirements.

Skills

Quality improvement

HEDIS

NCQA

Education

Bachelor's degree in Business or related field

Job description

Centene Corporation is seeking a Quality Improvement professional to lead performance improvement initiatives focused on clinical quality and measure outcomes. The role supports NCQA/HEDIS activities, accreditation readiness, and delegated vendor coordination.

The position emphasizes policy development, training, and audits to ensure compliance with state and federal requirements. Remote work within the continental United States is supported.