Senior Quality & Performance Programs Manager

Centene Management Company LLC; United States; Híbrido; USD 70.000 - 126.000; Jornada completa

Descripción de la vacante

Centene Management Company LLC in the United States seeks a Program Development Manager to collaborate across Quality, Health Services and Operations to develop and implement standards, policies, workflows, and decision-support systems for clinical and administrative operations.

You will oversee program design and execution aligned with regulatory and quality requirements, lead performance improvement projects, and partner with analytics teams to drive data-informed improvements in member care

Formación

• 5+ years of experience in direct program development, program management, and/or project management, preferably in a healthcare environment
• 3+ years of experience in managed care, plus utilization management, care coordination, disease management, Medicare, Medicaid, DSNP, dual eligibles, PCMH
• 2+ years of experience in design, develop and implement STARS, CAHPS, HEDIS and other enterprise quality related programs across a variety of settings including: defining the eligible population, service mix, delivery system configuration and financing; integration of behavioral, clinical, social, and community health care for members with multiple chronic conditions; working with multiple market leaders to coordinate consistent quality initiatives; conducting assessments, contractual reviews, and business plans for new quality improvement, including internally sourced or vendor sourced quality programs, and/or the integration of innovative approaches to defined programs to improve quality ratings company wide.

Responsabilidades

• Oversees the creation and implementation of programs relevant to the organization’s strategic initiatives involving Health Services, clinical and operational quality administration.
• Designs and facilitates the development of various programs/systems, work flows, and integration efforts in alignment with Corporate, market, contractual, regulatory and quality requirements.
• Leads state required Performance Improvement Projects (PIP) including topic selection, root cause analysis, implementation, and final submission.
• Partners with leaders and members of the Quality Analytics and Improvement Teams and determines data needs as well as assists in designing tools and reports as necessary.

Conocimientos

Program development

Program management

Project management

Healthcare quality

Educación

Bachelor's degree

Master's degree

Descripción del empleo

Centene Management Company LLC in the United States seeks a Program Development Manager to collaborate across Quality, Health Services and Operations to develop and implement standards, policies, workflows, and decision-support systems for clinical and administrative operations.

You will oversee program design and execution aligned with regulatory and quality requirements, lead performance improvement projects, and partner with analytics teams to drive data-informed improvements in member care