Risk Adjustment & Quality Improvement Leader - Remote

Centene Management Company LLC; Pennsylvania; Hybrid; USD 88,000 - 158,000; 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 Management Company LLC in Pennsylvania seeks a seasoned professional to manage risk adjustment and quality improvement for assigned products and plans. You will develop and implement action plans across departments, address issues identified by business units, and create workplans, issue logs, and progress reports.

You will partner with multiple teams to translate business requirements into operational workflows, evaluate the risk adjustment strategy, support health plan initiatives, and

Qualifications

• Bachelor’s degree required or equivalent experience in a related field.
• 4+ years of project management, operations, quality improvement or data analysis/reporting experience in the healthcare industry.
• Clinical or Social work experience preferred; managed care or Medicare experience preferred; MLTSS experience is a plus.

Responsibilities

• Develop and implement action plans across departments for risk adjustment and quality initiatives.
• Prepare dashboards for senior management and identify improvement opportunities.
• Lead cross-department collaboration to execute product and program requirements.
• Evaluate and manage risk adjustment strategy across functional areas affecting assigned products.

Skills

Project management

Operations

Quality improvement

Data analysis

Healthcare industry experience

Education

Bachelor’s degree in related field

Job description

Centene Management Company LLC in Pennsylvania seeks a seasoned professional to manage risk adjustment and quality improvement for assigned products and plans. You will develop and implement action plans across departments, address issues identified by business units, and create workplans, issue logs, and progress reports.

You will partner with multiple teams to translate business requirements into operational workflows, evaluate the risk adjustment strategy, support health plan initiatives, and