Remote Quality Improvement Coordinator — Behavioral Health

Louisiana Healthcare Connections, Inc.; Louisiana; Hybrid; USD 46.000 - 84.000; Vollzeit

Zusammenfassung

Centene is hiring in Louisiana to analyze, develop and monitor clinical quality initiatives within the Behavioral Health domain. The role focuses on reviewing clinical information for appeals, determining medical necessity, and leading improvement projects to meet NCQA/state requirements.

Strong nursing background and quality/managed care experience are essential. This full-time role offers flexible schedules including remote, hybrid, field, or office work and a competitive benefits package;

Qualifikationen

• Associate's Degree in Nursing or related field required.
• 2+ years in Clinical Nursing or Behavioral Health required.
• 1+ years in Quality, Managed Care or Healthcare Administration required.

Aufgaben

• Analyze, develop and monitor clinical quality initiatives and ensure NCQA and state standards compliance.
• Lead Behavioral Health Performance Improvement Projects (PIPS).
• Review clinical information for appeals to determine medical necessity.

Kenntnisse

Clinical Nursing

Behavioral Health

Quality

Ausbildung

Associate's Degree in Nursing or related field

Jobbeschreibung

Centene is hiring in Louisiana to analyze, develop and monitor clinical quality initiatives within the Behavioral Health domain. The role focuses on reviewing clinical information for appeals, determining medical necessity, and leading improvement projects to meet NCQA/state requirements.

Strong nursing background and quality/managed care experience are essential. This full-time role offers flexible schedules including remote, hybrid, field, or office work and a competitive benefits package;