Senior Quality Improvement Lead – Medicaid Programs

Centene Corp.; Kansas; Hybrid; USD 70,000 - 126,000; Full time

Benefits offered by this job

Comprehensive benefits package

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules

Job summary

Centene Corp. in the United States seeks a Senior Quality Improvement Specialist to coordinate regulatory, accreditation and service improvement programs.

You will lead Medicaid state withhold and pay-for-performance initiatives, develop measure-level action plans, monitor performance, and report to senior leadership. The role requires 3+ years in a clinical/health care setting, a clinical license (CPHQ preferred), and strong project management skills; remote/hybrid/work options may be available

Qualifications

• Bachelor’s degree or equivalent with clinical license; MPH/MPA master’s is acceptable.
• Valid state clinical license preferred; CPHQ preferred.
• Minimum three years in clinical/health care with related degree.
• Three to five years managed care experience; compliance/accreditation/quality improvement.
• Complex project management experience; Medicare/NCQA experience preferred.

Responsibilities

• Lead multiple complex quality improvement initiatives across Medicaid withhold and pay-for-performance programs.
• Interpret contractual requirements and performance targets; develop action plans and interventions.
• Coordinate with cross-functional teams, leadership, and state partners.
• Develop and maintain program documents, reports and governance materials.
• Produce internal/external communications and presentations for senior staff.
• Lead cross-department committees; identify improvement opportunities and measure outcomes.
• Manage vendor oversight and promote participation in quality collaboratives.
• Monitor regulation, accreditation standards, and industry best practices.

Skills

Clinical license

Project management

Quality improvement

Regulatory compliance

Stakeholder coordination

Education

Bachelor’s degree or equivalent experience with clinical license or Master’s Degree in related health field (i.e. MPH or MPA)

Job description

Centene Corp. in the United States seeks a Senior Quality Improvement Specialist to coordinate regulatory, accreditation and service improvement programs.

You will lead Medicaid state withhold and pay-for-performance initiatives, develop measure-level action plans, monitor performance, and report to senior leadership. The role requires 3+ years in a clinical/health care setting, a clinical license (CPHQ preferred), and strong project management skills; remote/hybrid/work options may be available