Centene Corporation
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Quality Program Strategist II
role at
Centene Corporation
Applicants may work remotely from home; occasional travel up to 10% may be required. Candidates should have a deep understanding of CAHPS and HOS and be located in Eastern or Central time zone.
Position Purpose Identify market trends and oversee functions of quality improvement programs for HEDIS, CAHPS, and/or HOS strategy and related quality improvement activities. Assists stakeholders to determine their business issues and recommend solutions to drive business value. Analyze stakeholder business issues, formulate hypotheses and test conclusions to determine appropriate solutions.
Responsibilities
Conduct evaluations to assist with HEDIS gap closure, CAHPS and/or HOS performance and assess potential pilot programs and process improvements to achieve sustainable quality performance goals.
Perform end‑to‑end evaluation of measure technical specifications, performance trends, stakeholders, industry/research literature, organizational initiatives, policies, procedures, resources, and tools.
Leverage data analysis to derive actionable insights and strategic recommendations for performance improvements.
Collaborate and provide support to markets and key business stakeholders to drive continued measure performance.
Develop HEDIS, CAHPS, and/or HOS support resources and tools to foster gap closure and improve experience for members and providers.
Conduct ongoing assessment to determine health plan needs, collaborating with cross‑functional teams to ensure successful end‑to‑end execution of strategic initiatives.
Monitor and ensure compliance related to state reporting, HHS and HPMS memos for quality ratings.
Establish quality check policies and procedures for all member and provider communications to ensure accuracy of information, data, and alignment with Centene business goals.
Create, maintain and facilitate training for Quality Improvement Health Plan staff as applicable to assigned responsibility.
Perform other duties as assigned and comply with all policies and standards.
Qualifications • Bachelor’s degree in Nursing, Public Health, related field, or equivalent experience. • Master’s degree preferred. • 4+ years of clinical experience, managed care or health insurance experience required. • 2+ years of quality experience preferred.
License / Certification Registered Nurse (RN), Licensed Practical Nurse, Licensed Vocational Nurse, Licensed Clinical Social Worker (LCSW) preferred; CPHQ preferred.
Pay Range & Benefits 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.
Equal Opportunity Employer 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.
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Quality Program Strategist II
role at
Centene Corporation
Applicants may work remotely from home; occasional travel up to 10% may be required. Candidates should have a deep understanding of CAHPS and HOS and be located in Eastern or Central time zone.
Position Purpose Identify market trends and oversee functions of quality improvement programs for HEDIS, CAHPS, and/or HOS strategy and related quality improvement activities. Assists stakeholders to determine their business issues and recommend solutions to drive business value. Analyze stakeholder business issues, formulate hypotheses and test conclusions to determine appropriate solutions.
Responsibilities
Conduct evaluations to assist with HEDIS gap closure, CAHPS and/or HOS performance and assess potential pilot programs and process improvements to achieve sustainable quality performance goals.
Perform end‑to‑end evaluation of measure technical specifications, performance trends, stakeholders, industry/research literature, organizational initiatives, policies, procedures, resources, and tools.
Leverage data analysis to derive actionable insights and strategic recommendations for performance improvements.
Collaborate and provide support to markets and key business stakeholders to drive continued measure performance.
Develop HEDIS, CAHPS, and/or HOS support resources and tools to foster gap closure and improve experience for members and providers.
Conduct ongoing assessment to determine health plan needs, collaborating with cross‑functional teams to ensure successful end‑to‑end execution of strategic initiatives.
Monitor and ensure compliance related to state reporting, HHS and HPMS memos for quality ratings.
Establish quality check policies and procedures for all member and provider communications to ensure accuracy of information, data, and alignment with Centene business goals.
Create, maintain and facilitate training for Quality Improvement Health Plan staff as applicable to assigned responsibility.
Perform other duties as assigned and comply with all policies and standards.
Qualifications • Bachelor’s degree in Nursing, Public Health, related field, or equivalent experience. • Master’s degree preferred. • 4+ years of clinical experience, managed care or health insurance experience required. • 2+ years of quality experience preferred.
License / Certification Registered Nurse (RN), Licensed Practical Nurse, Licensed Vocational Nurse, Licensed Clinical Social Worker (LCSW) preferred; CPHQ preferred.
Pay Range & Benefits 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.
Equal Opportunity Employer 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.
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