Vice President, Quality Improvement
Centene Corporation
full-time
Posted on:
Location Type: Hybrid
Location: Indianapolis • United States
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Salary
💰 $180,400 - $343,300 per year
Job Level
About the role
- Oversee all related activities for the Quality Improvement functions
- Lead and direct process improvement activities for more efficient and streamlined workflow
- Oversee the business processes related to risk adjustment and quality improvement for assigned products and plans
- Responsible for all activities related to NCQA Accreditation and/or HEDIS performance ensuring highest level of accreditation
- Manage all aspects of HEDIS improvement activities, including outreach, incentives, data integrity and chart review
- Review and implement new technological tools and processes and foster team concept with internal and external constituencies
- Present results of improvement efforts and ongoing performance measures and recommend actions plans to senior management
- Research and incorporate quality improvement best practices into operations
- Organize and control activities, methods, and procedures to achieve business objectives
- Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines
- Manage and ensure compliance of EPSDT program as well as compliance and turnaround time of grievances and appeals
Requirements
- Bachelor's Degree in Nursing or related clinical field or equivalent experience required, Master's Degree preferred
- 10+ years of healthcare operations experience, including quality improvement and NCQA accreditation experience required
- Experience managing acquisition and integration of external data sources
- Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff
- Familiarity with running Risk Adjustment prospective and retrospective programs 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 & Tools
quality improvementprocess improvementHEDIS performancedata integritychart reviewrisk adjustmentaccreditationcompliance managementpolicy formulationoperating procedures
Soft Skills
leadershiporganizational skillscommunicationteam collaborationperformance managementstrategic planningproblem-solvingresearch skillspresentation skillsinterpersonal skills
Certifications
Bachelor's Degree in NursingMaster's Degree in related fieldNCQA Accreditation