Remote Quality Program Strategist II - HEDIS & CAHPS

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

Job summary

Centene Corporation seeks a Quality Improvement professional to lead HEDIS, CAHPS and HOS strategy, guiding end-to-end quality initiatives across markets. You will analyze trends, collaborate with stakeholders, and develop resources to close gaps in member experience and performance.

The role requires 4+ years in clinical or health-insurance quality roles, with RN/LPN/LCSW background preferred; remote work with EST alignment is offered.

Qualifications

• Experience with CAHPS and HOS strongly preferred.
• 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

• Conduct evaluations to assist with HEDIS gap closure, CAHPS and/or HOS performance and assess for potential pilot programs and/or process improvements to achieve sustainable quality performance goals.
• Leverage data analysis to derive actionable insights and strategic recommendations for performance improvements.
• Collaborate with markets & key business stakeholders to drive continued measure performance.
• Develop HEDIS, CAHPS, and/or HOS support resources and tools to foster gap closure and improve member/provider experience.
• Monitor compliance related to state reporting, HHS and HPMS memos for quality ratings.

Skills

CAHPS

HEDIS

Quality Improvement

Data analysis

Stakeholder collaboration

Education

Bachelor’s degree in Nursing, Public Health, related field

Master’s degree preferred

Job description

Centene Corporation seeks a Quality Improvement professional to lead HEDIS, CAHPS and HOS strategy, guiding end-to-end quality initiatives across markets. You will analyze trends, collaborate with stakeholders, and develop resources to close gaps in member experience and performance.

The role requires 4+ years in clinical or health-insurance quality roles, with RN/LPN/LCSW background preferred; remote work with EST alignment is offered.