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Lead Quality Improvement Coordinator

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This job is available in 4 locations

Lead Quality Improvement Coordinator

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Description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: Lead quality improvement initiatives as the subject matter expert in a variety of areas including utilization management, credentialing reviews and medical audits. Train, develop and organize staff to implement quality initiatives under manager’s supervision.

This position is remote, work from home but must reside in South Carolina. We are looking for a LVN/LPN or RN for this position.

  • Field questions and escalated issues related to HEDIS and NCQA.
  • Monitor team performance.
  • Recognize and anticipate issues to report to the Manager.
  • Conduct monthly audits to identify trends.
  • With the Manager, develop actions for improvement based on identified trends.
  • Create reports and presentations for meetings.
  • Gather, analyze, and complete reports for Manager for review.
  • Review, maintain, update and revise internal Procedures on an ongoing basis.
  • Train staff on processes, procedures, and IT systems.
Education/Experience: Bachelor’s degree in Nursing preferred. 4+ years of clinical, quality improvement or healthcare experience. 3+ years of experience in quality function in a healthcare setting.

License/Certification: LPN, LVN, RN, PA, or LCSW license preferred. CPHQ (Certified Professional in Healthcare Quality) preferred.Pay Range: $67,400.00 - $121,300.00 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.

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