Quality of Care Coordinator

As a Quality of Care Coordinator at Centene, your primary responsibilities include reviewing medical records to identify Quality of Care (QOC) incidents and assessing whether care standards have been met. You'll assign initial severity levels for incidents and compile detailed timelines and summaries for presentation to the medical director. Additionally, you'll ensure compliance with organizational policies and clinical protocols and may participate in peer review committees to discuss findings and next steps.

To be considered for the Quality of Care Coordinator role at Centene, candidates should possess at least an Associate’s degree in Nursing, with a Bachelor's degree preferred. Moreover, a minimum of three years of nursing or related healthcare experience is required. Having a current RN or LCSW license is essential, while certification as a CPHQ is advantageous in showcasing your quality healthcare expertise.

The pay range for the Quality of Care Coordinator position at Centene is between $33.03 and $59.47 per hour. Actual compensation is influenced by the individual's skills, experience, education, and other relevant job-related factors permitted by law. This ensures that we recognize and reward your unique qualifications appropriately.

Yes, Centene offers a flexible approach to work schedules, including options for remote, hybrid, field, or office work for the Quality of Care Coordinator role. This flexibility is designed to accommodate the diverse needs of our employees, promoting a healthy work-life balance while delivering high-quality care to our members.

Centene provides a comprehensive benefits package for Quality of Care Coordinators, including competitive pay, health insurance, a 401K plan, stock purchase options, tuition reimbursement, paid time off along with holidays, and a range of flexibility in work arrangements. Our commitment to employee well-being goes beyond compensation, focusing also on personal and professional growth.

Key skills for a Quality of Care Coordinator include strong analytical abilities for reviewing medical records, excellent communication skills for summarizing findings to healthcare professionals, and a deep understanding of clinical guidelines. Additionally, time management and critical thinking are essential for prioritizing tasks and making informed decisions.

In handling discrepancies in medical records, approach the situation with careful investigation. Discuss the findings with relevant medical staff to gain insight and clarity. Following this, document any inconsistencies thoroughly and recommend further review or intervention as necessary, ensuring compliance with care standards.

When asked about identifying a quality of care issue, describe a specific instance where you utilized your analytical skills to notice a trend in patient records that indicated a potential lack of care. Explain your analysis process and how you collaborated with your team to address the issue effectively.

For assessing quality of care, I frequently rely on established clinical guidelines and evidence-based frameworks. I use tools such as the Plan-Do-Study-Act (PDSA) cycle to monitor quality improvements and make adjustments as needed, ensuring that our care meets established standards.

When prioritizing tasks as a Quality of Care Coordinator, I assess the urgency of each issue based on impact and compliance requirements. Utilizing checklists and maintaining clear communication with team members helps streamline efforts and ensures critical tasks are addressed promptly.

In my previous roles, I have been deeply involved in adhering to compliance and regulatory standards, ensuring that all medical record reviews meet organizational policies. I stay current with industry regulations and continuously educate my team on compliance issues for effective implementation.

Effective team collaboration hinges on open communication and active engagement. I implement regular check-ins and encourage feedback to foster an inclusive environment where team members feel valued and motivated to contribute their insights, which ultimately enhances our quality of care.

I stay updated by reading reputable healthcare journals, attending workshops and conferences, and engaging in professional organizations focused on healthcare quality. By regularly seeking out continuing education opportunities, I ensure my strategies and approaches remain current and effective.

Technology plays a critical role in my work. Utilizing electronic health records (EHR) enhances efficiency in reviewing medical records. I also leverage data analytics tools to quantitatively assess and identify trends in quality of care, which aids in developing targeted improvements.

When answering why I want to work for Centene, I highlight the company's commitment to improving health outcomes for members and its reputation for flexibility and employee satisfaction. I believe my values align with Centene's mission to deliver high-quality care and support the health needs of diverse populations.