Operations Advisor – Set Up
United Franchise Group
Director, Quality Improvement, HEDIS Operations
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Remote • Illinois • 🇺🇸 United States
Visit company websiteSalary
💰 $116,100 - $214,700 per year
Job Level
Lead
About the role
- Lead and direct process improvement activities that provide more efficient and streamlined workflow.
- Responsible for leading and collaborating with others on National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance.
- Responsible for quality improvement aspects of risk adjustment processes for all products.
- Collaborate with Medicare STARS team to improve overall STARS ratings for Medicare products (including HEDIS, CAHPS, HOS).
- Oversee provider satisfaction surveys and implement action plans for improvements.
- Research and incorporate best practices into operations.
- Organize and control activities, methods, and procedures to achieve business objectives.
- Review and implement new technological tools and processes and fosters team concept with internal and external constituencies.
- Present results of improvement efforts and ongoing performance measures to senior management.
- Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines.
- Performs other duties as assigned.
- Complies with all policies and standards.
Requirements
- Bachelor's Degree Nursing, other related field or equivalent experience required
- Master's Degree preferred
- 7+ years of quality management, quality improvement or healthcare operations experience required
- Certified Professional in Health Care Quality preferred
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
quality managementquality improvementhealthcare operationsrisk adjustment processesprocess improvementperformance measuresNCQA AccreditationHEDISMedicare STARSCAHPS
Soft skills
leadershipcollaborationorganizational skillscommunicationresearchproblem-solvingpresentation skillsteamworkstrategic planningpolicy formulation
Certifications
Bachelor's DegreeMaster's DegreeCertified Professional in Health Care Quality
