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Supervisor, Quality Improvement Audits

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  • Business Area: Quality
  • Job Type: Full time
  • Date Posted:
  • Job Number: 1497900
This job is available in 1 locations

Supervisor, Quality Improvement Audits

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Description

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.

Position Purpose: Identify, develop and monitor performance improvement audit activities, including measurement tool, sample frames and target outcomes. Coordinate and monitor quality improvement audit projects from inception to completion. Develop a cross-departmental comprehensive provider audit schedule.
  • Supervise a team of auditors to ensure provider audits are conducted according to State contractual requirements, including inter-rater reliability.
  • Assist in the creation and implementation of the Annual Quality Improvement Work Plan and Evaluation, including the annual cross-departmental audit schedule.
  • Develop, implement and educate various departments and practitioner/facility staff on performance measures specifications to ensure accurate measurement application and valid data
  • Facilitate cross functional improvement teams based on rapid improvement cycling to drive improved systems performance based on trended audit results.
  • Prepare quarterly and annual performance reports for the Executive Management Team and the Quality Management Department
  • Develop presentations of provider performance for use in reporting
  • Apply statistics testing to all data sets for quantitative analysis for provider performance

For Fidelis Care only:
  • Supervise a team of auditors to ensure provider audits and Medical Records retrieval projects are conducted according to State contractual requirements, including inter-rater reliability.
  • Develop, implement and educate various departments and practitioner/facility staff on member outreach, quality programs and performance measures specifications to ensure accurate measurement application and valid data.
Education/Experience: Bachelor’s degree in Healthcare, Business Management related field, or related or equivalent experience. 3+ years of quality improvement experience, preferably in managed health care. Experience with the use of statistics software and applications.

License/Certificates: Certified Professional in Healthcare Quality (CPHQ) preferred. Up to 25% travel and personal vehicle and valid Driver’s License required.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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