Join our team of visionary healthcare professionals and play a pivotal role in shaping the future of healthcare for our 28 million members. As a clinical expert on our Medical Management/Health Services team, you will have the opportunity to make a lasting impact on the lives of our members. At Centene, we offer a unique blend of competitive benefits, flexible work arrangements, and a collaborative work environment that fosters innovation and growth.
The primary purpose of this role is to supervise and coordinate a team of professionals to ensure the accuracy and reporting of HEDIS data, including investigations, auditing, and identification of improvement opportunities. You will collaborate with internal and external stakeholders to integrate HEDIS and CAHPS initiatives across the organization, driving meaningful outcomes for our members.
Key responsibilities include:
- Coordinating activities, resources, and procedures to achieve improvement in HEDIS measures, in collaboration with business leaders and cross-functional departments
- Ensuring compliance with HEDIS technical specifications, policies, and operating procedures, in accordance with internal and external guidelines
- Supervising daily staff activities to promote quality improvement and efficient methods
- Conducting comprehensive analysis of HEDIS measures, barriers, and opportunities, and presenting results to stakeholders
- Coordinating clinical quality metrics and HEDIS processes, including cross-functional processes to request and evaluate member compliance reports
- Managing HEDIS projects, including assignment of nurses, adherence to timelines, and vendor oversight
- Ensuring compliance with quality audits and maintaining data and process controls
To be successful in this role, you should be located in Ohio or surrounding states and possess:
- A Bachelor's degree in Business Administration, Healthcare Administration, or equivalent experience
- At least 3 years of experience in quality improvement, HEDIS project management, or healthcare-related fields
- Working knowledge of NCQA and HEDIS programs
We offer a competitive pay range of $68,700.00 - $123,700.00 per year, as well as a comprehensive benefits package, including:
- Competitive pay and health insurance
- 401K and stock purchase plans
- Tuition reimbursement and paid time off
- A flexible approach to work, with remote, hybrid, field, or office work schedules
At Centene, we are committed to diversity, equity, and inclusion, and value the unique perspectives and experiences of our employees. We are an equal opportunity employer and welcome applications from qualified candidates without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Apply Now to join our team and make a difference in the lives of our members.
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