Supervisor, Quality Improvement Audits

Centene; United States; Remote; USD 68,000 - 124,000; Full time

Job summary

Centene is seeking a Quality Improvement Auditor to oversee audit activities ensuring compliance with state requirements. This role involves managing a team, developing performance measures, and conducting analysis to improve healthcare quality. Candidates must have a Bachelor's degree and relevant experience in quality improvement.

Benefits

Health insurance

401K

Tuition reimbursement

Paid time off

Flexible work schedules

Qualifications

• 3+ years of quality improvement experience in managed health care.
• Experience with cross-departmental audit project management.
• Knowledge of performance measurement specifications.

Responsibilities

• Supervise a team of auditors for state compliance.
• Develop and monitor audit activities and schedules.
• Prepare performance reports for management.

Skills

Quality Improvement

Statistical Analysis

Audit Management

Education

Bachelor’s degree in Healthcare or Business Management

Tools

Statistics software

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Must reside in Arizona or Nevada.

Position Purpose: Identify, develop and monitor performance improvement audit activities, including measurement tool, sample frames and target outcomes. Coordinate and monitor quality improvement audit projects from inception to completion. Develop a cross-departmental comprehensive provider audit schedule.

• Supervise a team of auditors to ensure provider audits are conducted according to State contractual requirements, including inter-rater reliability.
• Assist in the creation and implementation of the Annual Quality Improvement Work Plan and Evaluation, including the annual cross-departmental audit schedule.
• Develop, implement and educate various departments and practitioner/facility staff on performance measures specifications to ensure accurate measurement application and valid data
• Facilitate cross functional improvement teams based on rapid improvement cycling to drive improved systems performance based on trended audit results.
• Prepare quarterly and annual performance reports for the Executive Management Team and the Quality Management Department
• Develop presentations of provider performance for use in reporting
• Apply statistics testing to all data sets for quantitative analysis for provider performance

Must reside in Arizona or Nevada.

Education/Experience: Bachelor’s degree in Healthcare, Business Management related field, or related or equivalent experience. 3+ years of quality improvement experience, preferably in managed health care. Experience with the use of statistics software and applications.

License/Certificates: Certified Professional in Healthcare Quality (CPHQ) preferred. Up to 25% travel and personal vehicle and valid Driver’s License required.

Pay Range: $68,700.00 - $123,700.00 per year

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Must reside in Arizona or Nevada.

Position Purpose: Identify, develop and monitor performance improvement audit activities, including measurement tool, sample frames and target outcomes. Coordinate and monitor quality improvement audit projects from inception to completion. Develop a cross-departmental comprehensive provider audit schedule.

• Supervise a team of auditors to ensure provider audits are conducted according to State contractual requirements, including inter-rater reliability.
• Assist in the creation and implementation of the Annual Quality Improvement Work Plan and Evaluation, including the annual cross-departmental audit schedule.
• Develop, implement and educate various departments and practitioner/facility staff on performance measures specifications to ensure accurate measurement application and valid data
• Facilitate cross functional improvement teams based on rapid improvement cycling to drive improved systems performance based on trended audit results.
• Prepare quarterly and annual performance reports for the Executive Management Team and the Quality Management Department
• Develop presentations of provider performance for use in reporting
• Apply statistics testing to all data sets for quantitative analysis for provider performance

Must reside in Arizona or Nevada.

Education/Experience: Bachelor’s degree in Healthcare, Business Management related field, or related or equivalent experience. 3+ years of quality improvement experience, preferably in managed health care. Experience with the use of statistics software and applications.

License/Certificates: Certified Professional in Healthcare Quality (CPHQ) preferred. Up to 25% travel and personal vehicle and valid Driver’s License required.

Pay Range: $68,700.00 - $123,700.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law , including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

About the company

Centene Corporation is a publicly traded managed care company based in St.

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