Manager, Quality Improvement

Centene
Arkansas
Workplace: HybridFull timeUSD 87,700 - 157,800 annuallyFunction: Quality & Regulatory (Non-Software)Experience: 3+ yearsEducation: bachelorsSkills: ["Communication","Data analysis","Compliance","Supervision","Budgeting"]

Oversee and manage the quality improvement program, including reviewing and analyzing reports, records, and directives to support daily QI activities. Partner with staff and departments to plan work functions, verify data submission requirements, and ensure compliance with state, federal, and certification standards. Lead complaint and appeals documentation and resolution, prepare management reports, evaluate procedures for continuous improvement, and monitor costs and budgeting.

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FursaFursa
Centene
Centene
2 days ago

Manager, Quality Improvement

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Source: Company careers pageValidated by: Fursa AI
Last checked: 2 hours agoStatus: Live

Job Summary

Oversee and manage the quality improvement program, including reviewing and analyzing reports, records, and directives to support daily QI activities. Partner with staff and departments to plan work functions, verify data submission requirements, and ensure compliance with state, federal, and certification standards. Lead complaint and appeals documentation and resolution, prepare management reports, evaluate procedures for continuous improvement, and monitor costs and budgeting.
Location: Arkansas
Workplace: Hybrid
Employment Type: Full time
Job Function: Quality & Regulatory (Non-Software)
Seniority: Manager level

Key Responsibilities

  • •Oversee and manage the quality improvement program and daily QI functions.
  • •Review and analyze reports, records, and directives; prepare reports and records for management.
  • •Confer with staff to obtain data for planning, verify data submissions, and ensure compliance with program requirements.
  • •Evaluate and improve current procedures and practices to meet objectives and required standards.
  • •Collaborate with departments to document, investigate, and resolve complaints and appeals; monitor costs and support budgeting.

Pay and Benefits

Salary: USD 87,700 - 157,800 annually
Perks:Health Insurance401kEquityPaid Leave

Key Requirements

  • •Bachelor’s degree in a related field or equivalent experience.
  • •3+ years of clinical, quality management, or healthcare-related experience, including 1 year of recent quality improvement and supervisory experience in a healthcare environment (preferably managed care).
  • •Experience with managed care and quality improvement initiatives, including Medicare STARS and HEDIS.
  • •Experience with provider engagement, gap closure strategies, and electronic data submissions (including supplemental data sources, flat files, and hybrid review processes).
  • •Ability to verify data for submission and ensure compliance with state, federal, and certification program requirements.
Experience:3+ yearsHealthcareQuality improvementManaged care
Education:Bachelor's in related field
Skills:CommunicationData analysisComplianceSupervisionBudgeting
Licenses:State registered nursing license
Certifications:Certified Professional in Healthcare
Tech Stack:Electronic data submissions

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn