Process Improvement Specialist (Clinical)

Centene
Detroit
Workplace: RemoteFull timeUSD 70,100 - 126,200 annuallyFunction: Communications, PR & CommunityExperience: 5+ yearsEducation: bachelorsSkills: ["Process improvement","Project coordination","Subject matter expertise","Quality measure evaluation","Recommendations"]

Plan, develop, and track clinical process improvement and operational projects tied to health outcomes for products within the Medical Management/Health Services team. Serve as a primary subject matter expert, review clinical member materials, and act as a liaison for clinical initiatives including case/disease management and behavioral health. Evaluate quality measures and survey results, then recommend improvements and collaborate with analytics on reporting, scheduling, and process improvement initiatives.

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FursaFursa
Centene
Centene
2 days ago

Process Improvement Specialist (Clinical)

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Last checked: 2 hours agoStatus: Live

Job Summary

Plan, develop, and track clinical process improvement and operational projects tied to health outcomes for products within the Medical Management/Health Services team. Serve as a primary subject matter expert, review clinical member materials, and act as a liaison for clinical initiatives including case/disease management and behavioral health. Evaluate quality measures and survey results, then recommend improvements and collaborate with analytics on reporting, scheduling, and process improvement initiatives.
Location: Detroit
Workplace: Remote
Employment Type: Full time
Job Function: Communications, PR & Community
Seniority: Mid level

Key Responsibilities

  • •Plan, develop, and track clinical process improvement and operational projects related to clinical outcomes.
  • •Serve as the primary subject matter expert for clinical health outcomes.
  • •Review clinical member materials, including service coordination brochures, handbook references, and educational leaflets.
  • •Evaluate quality measures and quality-response reporting, and provide recommendations.
  • •Review member survey results and collaborate with the analytics team on process improvement reporting and scheduling.

Pay and Benefits

Salary: USD 70,100 - 126,200 annually
Perks:Health Insurance401kPaid Leave

Key Requirements

  • •Must reside in the state of Michigan.
  • •Bachelor’s degree in Healthcare or related field, or equivalent experience.
  • •5+ years of process improvement experience, preferably in a managed care environment.
  • •Experience coordinating projects is preferred.
  • •Current state’s RN license or LCSW license; a drivers license is preferred.
Experience:5+ yearsManaged care
Education:Bachelor's in Healthcare (or related field)
Skills:Process improvementProject coordinationSubject matter expertiseQuality measure evaluationRecommendations
Licenses:RNLCSW

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