Remote Quality Program Strategist – HEDIS/CAHPS

Centene Corporation; Kentucky; Remote; USD 70,000 - 126,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Job summary

Centene Corporation is seeking a Quality Improvement professional to identify market trends and oversee HEDIS, CAHPS, and HOS initiatives. The role supports stakeholder decisions, analyzes business issues, and tests hypotheses to drive value.

Remote in the U.S. with EST-aligned schedule, the candidate should have 4+ years in clinical or health plan quality roles and a RN/LCSW/related license; master’s degree is preferred. Strong experience with member engagement and compliance is expected.

Qualifications

• Bachelor’s degree in Nursing, Public Health, or related field; Master’s degree preferred.
• 4+ years of clinical experience, managed care or health insurance experience required; 2+ years of quality experience preferred.

Responsibilities

• Identify market trends and oversee quality improvement programs for HEDIS, CAHPS, and/or HOS strategies.
• Assist stakeholders to determine business issues and recommend solutions to drive business value.
• Analyze stakeholder issues, formulate hypotheses, test conclusions to determine appropriate solutions.
• Conduct evaluations to assist with HEDIS gap closure and CAHPS/HOS performance.
• Leverage data analysis to derive actionable insights for performance improvements.
• Collaborate with markets and key business stakeholders to drive measure performance.
• Develop resources and tools to foster gap closure and improve member/provider experience.
• Monitor compliance related to state reporting, HHS and HPMS memos.
• Establish QA/QPS policies for communications and program activities; ensure precise execution.
• Create, maintain and facilitate training for Quality Improvement Health Plan staff.
• Performs other duties as assigned; complies with policies and standards.

Skills

CAHPS

HEDIS

data analysis

stakeholder collaboration

member engagement

Education

Bachelor’s degree in Nursing

Public Health

Master’s degree preferred

Job description

Centene Corporation is seeking a Quality Improvement professional to identify market trends and oversee HEDIS, CAHPS, and HOS initiatives. The role supports stakeholder decisions, analyzes business issues, and tests hypotheses to drive value.

Remote in the U.S. with EST-aligned schedule, the candidate should have 4+ years in clinical or health plan quality roles and a RN/LCSW/related license; master’s degree is preferred. Strong experience with member engagement and compliance is expected.