Senior Quality Improvement Leader – Remote

Centene Management Company LLC; Kansas; Hybrid; USD 70,000 - 126,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Flexible schedules

Job summary

Centene Management Company LLC is seeking a Senior Quality Improvement Specialist to coordinate regulatory, accreditation, and quality improvement programs. The role leads cross-functional initiatives, focusing on Medicaid state withhold and pay-for-performance programs, with emphasis on performance targets, action plans, and reporting.

The candidate will develop collaborations with providers, manage complex projects, and ensure compliance with state and federal requirements.

Qualifications

• Bachelor’s Degree or equivalent experience with clinical license or Master’s Degree in related health field (i.e. MPH or MPA).
• Valid state clinical license preferred.
• Certified Professional in Health Care Quality (CPHQ) preferred.
• Three to five years managed care experience in a health care environment.
• Experience in compliance, accreditation, service or quality improvement.
• Complex project management experience.

Responsibilities

• Lead Medicaid state withhold and pay-for-performance programs, including interpretation of contractual requirements and performance targets.
• Develop and monitor measure-level action plans, interventions, reporting and financial impact.
• Coordinate with cross-functional teams, executive leadership and state partners to achieve outcomes.
• Conduct vendor oversight and management.
• Develop internal reports to demonstrate progress and present to senior staff.

Skills

Leadership

Project management

Quality improvement

Regulatory/compliance

Education

Bachelor’s Degree or equivalent with clinical license or Master’s in health field

Valid state clinical license (preferred)

Certified Professional in Health Care Quality (CPHQ) preferred

Job description

Centene Management Company LLC is seeking a Senior Quality Improvement Specialist to coordinate regulatory, accreditation, and quality improvement programs. The role leads cross-functional initiatives, focusing on Medicaid state withhold and pay-for-performance programs, with emphasis on performance targets, action plans, and reporting.

The candidate will develop collaborations with providers, manage complex projects, and ensure compliance with state and federal requirements.