Remote Quality Improvement Coordinator II (Clinical)

Centene Management Company LLC; Nevada; Hybrid; USD 46,000 - 84,000; Full time

Benefits offered by this job

competitive pay

health insurance

401K and stock purchase plans

tuition reimbursement

paid time off plus holidays

flexible work arrangements

Job summary

Centene Management Company LLC is seeking a Quality Improvement Coordinator to coordinate and monitor quality improvement and organizational projects from inception to closure. You will develop and implement QI programs at corporate and health plan levels, ensuring NCQA/URAC compliance and advocating for program enhancements.

The role requires a Nursing-related bachelor’s degree, 3+ years clinical experience and 1+ year in quality, with preference for NCQA/URAC/JCAHO accreditation familiarity.

Qualifications

• Bachelor’s degree in Nursing or related medical field preferred.
• 3+ years clinical experience and 1+ years of experience in a quality function.
• Hands on experience with writing and implementing policies and procedures to support NCQA/URAC or JCAHO accreditation standards preferred.
• Basic understanding of health insurance business, claims payment procedures, strategies and trends in health care preferred.

Responsibilities

• Coordinate and monitor quality improvement and organizational projects from inception to closure.
• Assist with Plan compliance to NCQA/URAC standards.
• Maintain Quality Improvement policies and procedures in compliance with NCQA/URAC requirements and recommend changes/enhancements as indicated.
• Identify best practices, research new processes and recommend overall program enhancements.
• Support the project life cycle including requirements gathering, creation of project plans and schedules, manage resources and facilitate project execution, deployment and closure.
• Assist with collection and presentation of data for identified QI projects; identifying sources, methodology and timeliness for which data is needed.

Skills

Quality Improvement

Project coordination

Data analysis

Policy writing

Compliance

Education

Bachelor’s degree in Nursing or related medical field

Job description

Centene Management Company LLC is seeking a Quality Improvement Coordinator to coordinate and monitor quality improvement and organizational projects from inception to closure. You will develop and implement QI programs at corporate and health plan levels, ensuring NCQA/URAC compliance and advocating for program enhancements.

The role requires a Nursing-related bachelor’s degree, 3+ years clinical experience and 1+ year in quality, with preference for NCQA/URAC/JCAHO accreditation familiarity.