Senior Quality Improvement Leader: Medicaid & Star Ratings

Centene Corporation; Kansas; Hybrid; USD 70.000 - 126.000; Vollzeit

Benefits dieser Stelle

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules (remote,Hybrid

Remote/Hybrid/Field/Office options

Zusammenfassung

Centene Corporation is seeking a Senior Quality Improvement Specialist to coordinate regulatory, accreditation, and service improvement programs across multiple initiatives. You will lead cross-functional teams, oversee program performance, and ensure compliance with standards.

The role focuses on Medicaid withhold and pay-for-performance programs, developing action plans, reporting, and collaborating with state partners to achieve outcomes.

Qualifikationen

• 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.

Aufgaben

• Lead multiple complex quality improvement initiatives impacting health care delivery and member outcomes.
• Ensure programs comply with accreditation, state and federal requirements.
• Develop and monitor action plans, interventions and reporting.
• Provide vendor oversight and management.
• Improve Star Ratings, HEDIS, CAHPS, HOS and provider satisfaction.

Kenntnisse

Leadership

Cross-functional collaboration

Project management

Regulatory/compliance understanding

Quality improvement

Ausbildung

Bachelor’s Degree or equivalent with clinical license

Master’s Degree in related health field (MPH/MPA)

Jobbeschreibung

Centene Corporation is seeking a Senior Quality Improvement Specialist to coordinate regulatory, accreditation, and service improvement programs across multiple initiatives. You will lead cross-functional teams, oversee program performance, and ensure compliance with standards.

The role focuses on Medicaid withhold and pay-for-performance programs, developing action plans, reporting, and collaborating with state partners to achieve outcomes.