Quality Improvement Specialist Sr

Centene
Missouri, Georgia, Florida, Iowa, South Carolina, Texas, Oklahoma
Workplace: RemoteFull timeUSD 70,100 - 126,200 annuallyFunction: Quality & Regulatory (Non-Software)Experience: 3+ yearsEducation: bachelorsSkills: ["Leadership","Communication","Collaboration","Project management"]

Coordinate large-scale regulatory, accreditation, clinical quality, and service improvement programs. Lead complex initiatives that improve health care delivery outcomes across national, regional, and multi-plan efforts, ensuring compliance with accreditation and state/federal requirements. Assess and refine interventions, oversee vendors, and drive measurable performance improvements across Star Ratings, HEDIS, CAHPS, and related metrics, while communicating results to internal and external stakeholders.

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Centene
Centene
4 days ago

Quality Improvement Specialist Sr

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Last checked: 3 days agoStatus: Live

Job Summary

Coordinate large-scale regulatory, accreditation, clinical quality, and service improvement programs. Lead complex initiatives that improve health care delivery outcomes across national, regional, and multi-plan efforts, ensuring compliance with accreditation and state/federal requirements. Assess and refine interventions, oversee vendors, and drive measurable performance improvements across Star Ratings, HEDIS, CAHPS, and related metrics, while communicating results to internal and external stakeholders.
Location: Missouri, Georgia, Florida, Iowa, South Carolina, Texas, Oklahoma
Workplace: Remote
Employment Type: Full time
Job Function: Quality & Regulatory (Non-Software)
Seniority: Mid level

Key Responsibilities

  • •Coordinate assigned regulatory, accreditation, clinical quality, and/or service improvement programs; lead multiple complex initiatives impacting health care quality and effectiveness.
  • •Ensure compliance of clinical and service improvement programs with accreditation standards and applicable state and federal requirements.
  • •Assess and refine program interventions to meet goals, improve effectiveness, and improve outcomes; develop internal reporting for senior-level staff.
  • •Develop and implement targeted activities to improve Star Ratings, HEDIS, CAHPS, HOS, provider satisfaction, and other performance measures.
  • •Provide vendor oversight and manage outreach/communication materials and cross-functional committee work supporting key initiatives.

Pay and Benefits

Salary: USD 70,100 - 126,200 annually
Perks:Health Insurance401k

Key Requirements

  • •Bachelor’s degree or equivalent experience with a clinical license, or a Master’s degree in a related health field (e.g., MPH or MPA).
  • •Minimum three years of experience in a clinical/health care environment with a related degree program.
  • •Experience with compliance, accreditation, service, or quality improvement.
  • •Three to five years of managed care experience in a health care environment.
  • •Complex project management experience; Medicare and/or NCQA experience preferred.
Experience:3+ yearsManaged careHealth careQuality improvement
Education:Bachelor's
Skills:LeadershipCommunicationCollaborationProject management
Licenses:State clinical license
Certifications:CPHQ

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