Description
Position Purpose:
Responsible for providing leadership and direction for clinical, quality, risk-adjustment, value-based contracts, and provider outreach functions. Responsible for supervision of QPA field staff and administrative personnel to increase member quality of care, reduce costs, and identify risk adjustment opportunities. Responsible for the oversight of programs to support company initiatives in clinical quality, risk-adjustment, and financial management and provide data analysis on program progress and outcomes.
- Provides supervision, coaching, training, and development of field staff
- Oversees and manages quality and risk-adjustment initiatives/programs
- Provides and analyzes reports to identify trends, opportunities and plan regarding progress and outcomes of initiatives
- Collaborates with other managers on overall strategy and direction for the team
- Collaborates with cross functional teams on joint initiatives
- Performs other duties as assigned
- Complies with all policies and standards
Must live in the Indianapolis, IN area and have reliable transportation, valid drivers' license and insurance. Must be willing to travel. Travel is around 30% of the time.
Education/Experience: A bachelor’s degree in health care, Nursing, Public Health Administration or Business, or equivalent work experience is required. Health science related, preferably nursing. 3 years of experience. Some experiences functioning as a lead – 2+ years; 5 experience working in a managed care environment. Project management experience is preferred.
License/certification:
Required: One of the following - Certified Coding Specialist (CCS), Licensed Practical Nurse (LPN), Licensed Registered Nurse (RN), Acute Care Nurse Practitioner (APRN) (ACNP-BC), Licensed Vocational Nurse (LVN), Other Foreign trained physician/MD. Preferred - Health Care Quality and Management (HCQM), Certified Healthcare Professional (CHP), Certified Professional in Healthcare Quality (CPHQ).
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
