Remote Accreditation & Quality Improvement Lead

Centene Management Company LLC; United States; Remoto; USD 56.000 - 101.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules (remote,Hybrid

Field or office work options

Descrizione del lavoro

Centene Management Company LLC is seeking a clinical professional to drive Performance Improvement projects within the Medical Management/Health Services team. This remote role supports NCQA/HEDIS initiatives, accreditation readiness, and delegated vendor coordination across the continental United States.

Ideal candidates hold a Bachelor’s degree in Business, or related field, and 3+ years in quality improvement with NCQA/HEDIS experience.

Competenze

• Bachelor’s degree in Business, related field or equivalent experience.
• 3+ years of related quality improvement, HEDIS and/or NCQA experience.

Mansioni

• Develop Performance Improvement projects to improve clinical quality and performance measure outcomes.
• Develop and coordinate delegation oversight mechanisms and act as liaison for the Plan with Corporate Delegation Oversight.
• Develop and maintain accreditation readiness schedule.
• Creates 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.

Conoscenze

Quality improvement

HEDIS

NCQA

Formazione

Bachelor's degree in Business, related field or equivalent experience

Descrizione del lavoro

Centene Management Company LLC is seeking a clinical professional to drive Performance Improvement projects within the Medical Management/Health Services team. This remote role supports NCQA/HEDIS initiatives, accreditation readiness, and delegated vendor coordination across the continental United States.

Ideal candidates hold a Bachelor’s degree in Business, or related field, and 3+ years in quality improvement with NCQA/HEDIS experience.