Senior Healthcare Quality Coordinator (Apply in minutes)

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 competitivebenefits including a fresh perspective on workplace flexibility.

• Position Purpose :
• The Senior Quality Improvement Specialist is responsiblefor coordinating assigned regulatory, accreditation, clinical quality andorservice improvement programs. Functions as a leader for assigned healthservices initiatives handling multiple large-scale complex initiatives.Collaborates on national, regional and multi-plan initiatives. Developsprograms in compliance with accreditation and regulatory requirementsstandards and monitors ongoing program performance to maintain compliance.Acts as a resource for training, policy and regulatoryaccreditationinterpretation.
• Leads and manages multiple complex initiatives that impact the quality or effectiveness of health care delivery andor health care services provided to members.
• Ensures that clinical and service quality improvement programs and initiatives are compliant with applicable accreditation, state and federal requirements.
• Conducts an assessment of programs, initiatives and interventions to ensure goals and objectives were met and refine activities, as needed, to improve the effectiveness and improve outcomes.
• Conducts vendor oversight and management.
• Develops targeted activities to improve Star Ratings, HEDIS, CAHPS, HOS, provider satisfaction and other identified performance measures.
• Develops and implements project-related communication including, but not limited to, memberphysician mailings, IVR scripts, emails, business plans, graphics, and maintains minutes and agendas.
• Participates in the development and maintenance of annual quality improvement program documents and evaluations, compliance audits, policies and procedures, and improvement activities.
• Develops internal reports to demonstrate progress on each initiativeproject and presents to senior-level staff.
• Describes outreach initiatives, potentialexperienced barriers and activities to resolve issues and improve outcomes.
• Leads andor participates in multi-departmentcross-functional committees and work groups which support key initiatives, prepares reports, data, agendasminutes or other materials for committee presentation and management.
• Identifies areas of improvement within the company and works collaboratively with other departments to develop clinical and non-clinical performance improvement projects.
• Researches best practices, national and regional benchmarks, and industry standards.
• Develops collaborative relationships with contracted providers or provider groups to promote participation in quality improvement collaboratives to improve clinical care outcomes.
• May lead andor participate in external activities, work groups or committees when applicable.
• Communicates programs, interventions and results to external entities in accordance with applicable program objectives, policies and procedures.
• Develops andor maintains relationships with other external organizations to expand key partnerships.
• Assesses current industry trends and regulations for enterprise-wide adoption to assure quality and effectiveness of health care delivery andor healthcare services provided to members.
• Performs all other duties as assigned.
• Performs other duties as assigned
• Complies with all policies and standards
• EducationExperience :
• Education :
• Bachelor’s Degree or equivalent experience with clinicallicense or Master’s Degree in related health field (i.e. MPH or MPA)
• CertificationLicense :
• Valid state clinical license preferred Certified Professional in Health Care Quality (CPHQ) preferred.
• Experience :
• Minimum three years experience in a clinicalhealth careenvironment 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 andor NCQA preferred :
• Pay Range : $67,400.00 -$121,300.00 per yearCentene offers a comprehensive benefits package including : competitive pay,health insurance, 401K and stock purchase plans, tuition reimbursement, paidtime off plus holidays, and a flexible approach to work with remote, hybrid,field or office work schedules. Actual pay will be adjusted based on anindividuals skills, experience, education, and other job-related factorspermitted by law. Total compensation may also include additional forms ofincentives.Centene is an equal opportunity employer that is committed to diversity, andvalues the ways in which we are different. All qualified applicants willreceive consideration for employment without regard to race, color, religion,sex, sexual orientation, gender identity, national origin, disability, veteranstatus, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered inaccordance with the LA County Ordinance and the California Fair Chance Act

Salary : $67,400 - $121,300