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Director, Quality Improvement

  • Job
    Full-time
    Senior Level
  • Research & Development
    Healthcare
  • Germany, +15
    Remote

AI generated summary

  • You should have a Bachelor's in Nursing or related field, 7+ years in quality management, Medicare STARS expertise, and preferably a Master's degree and certifications in quality improvement.
  • You will lead quality improvement initiatives, enhance accreditation performance, collaborate on Medicare STARS ratings, oversee surveys, implement best practices, and present results to senior management.

Requirements

  • Medicare STARS Quality expertise heavily preferred
  • Remote opportunity
  • Bachelor's degree in Nursing, related clinical degree or equivalent experience.
  • 7+ years of quality management, quality improvement or healthcare operations experience.
  • Masters’ degree preferred.
  • Certain states may require a formal certification in quality improvement, risk management, or another parallel field.
  • Current state’s RN license preferred.
  • Certified Professional in Health Care Quality preferred.

Responsibilities

  • 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

FAQs

Is this position fully remote?

Yes, this position is a remote opportunity.

What educational qualifications are required for this role?

A Bachelor's degree in Nursing, a related clinical degree, or equivalent experience is required. A Master’s degree is preferred.

How many years of experience in quality management or healthcare operations is needed?

A minimum of 7 years of quality management, quality improvement, or healthcare operations experience is required for this position.

Is Medicare STARS Quality expertise necessary for this role?

Yes, Medicare STARS Quality expertise is heavily preferred for this position.

What certifications may be required or preferred for applicants?

Certain states may require formal certification in quality improvement or risk management. A current state’s RN license and Certified Professional in Health Care Quality are preferred.

What is the pay range for this position?

The pay range for this position is between $113,800.00 and $210,500.00 per year, depending on skills, experience, education, and other job-related factors.

Are there opportunities for professional development included in the benefits package?

Yes, the benefits package includes tuition reimbursement, allowing for professional development opportunities.

What types of benefits does Centene offer?

Centene offers competitive pay, health insurance, 401K and stock purchase plans, paid time off plus holidays, and a flexible approach to work.

Is Centene an equal opportunity employer?

Yes, Centene is an equal opportunity employer committed to diversity and values the unique differences of all qualified applicants.

Will applicants with arrest or conviction records be considered for employment?

Yes, qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.

Transforming the health of the communities we serve, one person at a time.

Science & Healthcare
Industry
10,001+
Employees
1984
Founded Year

Mission & Purpose

Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives. Centene offers affordable and high-quality products to nearly 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace and the TRICARE program. Centene believes healthcare is best delivered locally. Our local health plans provide fully integrated, high-quality, and cost-effective services to government-sponsored and commercial healthcare programs, focusing on under-insured and uninsured individuals. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities.