Senior Quality Improvement Lead — Medicaid & Compliance

Centene Corporation; Iowa; Hybrid; USD 70,000 - 126,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off + holidays

Remote/Hybrid/work flexibility

Job summary

Centene Corporation is seeking a Senior Quality Improvement Specialist to coordinate regulatory and accreditation programs, lead multi-plan initiatives, and drive performance improvements. The role requires collaboration with executive leadership and state partners to achieve outcomes and maintain compliance.

Responsibilities include developing action plans, monitoring performance metrics, and creating communications for stakeholders.

Qualifications

• Minimum three years experience in a clinical/health care environment with related degree program
• Three to five years managed care experience in a health care environment
• Experience in compliance, accreditation, service or quality improvement
• Complex project management experience
• Experience with Medicare and/or NCQA preferred

Responsibilities

• Leads and manages multiple complex initiatives that impact the quality or effectiveness of health care delivery and/or health care services provided to members
• Ensures that clinical and service quality improvement programs and initiatives are compliant with applicable accreditation, state and federal requirements
• Develops targeted activities to improve Star Ratings, HEDIS, CAHPS, HOS, provider satisfaction and other identified performance measures
• Develops internal reports to demonstrate progress on each initiative/project and presents to senior-level staff
• Describes outreach initiatives, potential/experienced barriers and activities to resolve issues and improve outcomes
• Leads and/or participates in multi-department/cross-functional committees and work groups which support key initiatives, prepares reports, data, agendas/minutes or other materials for committee presentation and management

Skills

Leadership

Project management

Quality improvement

Compliance

Vendor oversight

Stakeholder engagement

Regulatory knowledge

Data reporting

Education

Bachelor's degree

Master’s degree in health field

Clinical license

Job description

Centene Corporation is seeking a Senior Quality Improvement Specialist to coordinate regulatory and accreditation programs, lead multi-plan initiatives, and drive performance improvements. The role requires collaboration with executive leadership and state partners to achieve outcomes and maintain compliance.

Responsibilities include developing action plans, monitoring performance metrics, and creating communications for stakeholders.