Remote-Ready QA Specialist II for Process Improvement

Centene; United States; Hybrid; USD 52,000 - 68,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Remote/hybrid/field or office work

Job summary

Centene is seeking a Quality Assurance professional to assess and improve the quality of departmental interactions, systems, and processes across functions. The role emphasizes compliance with policies, audit readiness, and driving remediation for risk areas.

Candidate experience in Medicare contexts, grievance handling, and CTM is highly valued, along with strong analytical, audit, and root-cause analysis skills.

Qualifications

• Requires 1 - 2 years of related experience.
• Requires a High School diploma or GED.
• Vocational or technical education may be required.
• On-the-job training or continuous learning education may be included.

Responsibilities

• Monitors, inspects, and assesses the quality of interactions, systems, and processes to achieve established quality standards
• Documents and reports on quality, performance, and remediation efforts/progress of risks for leadership review and audit purposes
• Identifies improvement opportunities and provides guidance material to improve department processes
• Utilizes technology to continuously monitor and report on customer interaction performance
• Supports in preparing and distributing internal audit reports and findings to provide knowledge on quality improvements
• Assists as needed in coordinating document and data control (e.g., version control and numbering) to ensure accuracy and completeness
• Supports with random quality assurance checks to ensure compliance
• Upholds quality assurance policies and procedures and provides guidance or remediation plan when required
• Supports process improvement opportunities (process or technology) to continuously increase efficiency and effectiveness
• Assist with servicing members and/or providers as needed
• Actively participate in quality calibration sessions with quality team
• Assists with training of new hires as needed
• Performs other duties as assigned
• Complies with all policies and standards

Skills

Medicare experience

Grievance handling

CTM experience

Auditing

Analytical skills

Root cause analysis

Time management

Organization skills

Attention to detail

Education

High School diploma or GED

Vocational or technical education

Job description

Centene is seeking a Quality Assurance professional to assess and improve the quality of departmental interactions, systems, and processes across functions. The role emphasizes compliance with policies, audit readiness, and driving remediation for risk areas.

Candidate experience in Medicare contexts, grievance handling, and CTM is highly valued, along with strong analytical, audit, and root-cause analysis skills.