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Vice President, Quality Improvement
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Remote • Iowa, Kansas, Montana • 🇺🇸 United States
Visit company websiteSalary
💰 $213,300 - $403,700 per year
Job Level
Lead
About the role
- Oversee all Quality Improvement activities and initiatives across our health plans in Iowa, Missouri, and Kansas
- 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
- Manage all aspects of HEDIS improvement activities, including outreach, incentives, data integrity and chart review
- Responsible for compliance with National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance to ensure the highest level of accreditation and health plan rating
- Manage member engagement vendor including setting and monitoring performance standards
- 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
- Manage compliance of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program as well as compliance and turnaround time of quality of care reviews
- Responsible for all activities related to risk adjustment performance ensuring highest level of return
Requirements
- Master's Degree in Nursing or related clinical field or equivalent experience required
- 10+ years of experience managing acquisition and integration of external data sources required
- 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
- RN license and Certified Professional in Health Care Quality
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
process improvementHEDIS improvementdata integritychart reviewrisk adjustmentcompliance managementperformance measurementmember engagement managementquality improvement
Soft skills
leadershipteam collaborationcommunicationmanagementtrainingperformance management
Certifications
RN licenseCertified Professional in Health Care Quality
