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Director, Quality Improvement

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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 competitive benefits including a fresh perspective on workplace flexibility.

This is a remote position that will have national coverage working in multiple time zones supporting VBCs for Quality.

Position Purpose: 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

Education/Experience: 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

Pay Range: $116,100.00 - $214,700.00 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. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

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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CEO of Centene

Sarah London

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Average salary estimate

$165400 / YEARLY (est.)

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$116100K

$214700K

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What You Should Know About Director, Quality Improvement, Centene

Are you ready to make a difference? Join Centene as the Director of Quality Improvement and be the driving force behind our mission to transform the health of our 28 million members. This remote position allows you the flexibility to work across multiple time zones while leading vital quality improvement initiatives within our team. In this role, you'll take the reins on process improvement activities, ensuring our workflows are efficient and streamlined. You'll collaborate closely with various teams, including the National Committee for Quality Assurance (NCQA) and the Medicare STARS team, to enhance overall performance metrics like HEDIS and CAHPS. Your strategic oversight will include monitoring provider satisfaction surveys, implementing impactful action plans, and presenting results to senior management. With your extensive experience in healthcare operations and quality management, you’ll guide us in adopting new technological tools and best practices. At Centene, we believe in providing our employees with comprehensive benefits, a flexible work environment, and the opportunity to significantly impact community health. This role offers competitive pay, health benefits, and a supportive culture that values diversity. Step into a career where you can truly change lives.

Frequently Asked Questions (FAQs) for Director, Quality Improvement Role at Centene

What are the primary responsibilities of a Director of Quality Improvement at Centene?

As a Director of Quality Improvement at Centene, your primary responsibilities include leading process improvement initiatives, collaborating with the National Committee for Quality Assurance (NCQA) for accreditation, overseeing risk adjustment processes, and working with the Medicare STARS team to enhance product ratings. You will be expected to drive provider satisfaction improvements, research best practices, and ensure compliance with both internal and external guidelines.