Director, Quality Improvement – Digital Quality Measurement

🕒 Setembro 29

🏰 Missouri – Remoto

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💵 $107.700 - $199.300 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

👻 Score fantasma 0%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Centene Corporation

Centene Corporation

10.000+ funcionários

Fundada em 1984

🛡️ Seguros

💼 Consultoria

🏥 Saúde

Insurance • Consulting • Healthcare

Centene Corporation é uma provedora líder de serviços de saúde patrocinados pelo governo, especializada em oferecer soluções de saúde acessíveis e de alta qualidade. Há mais de 40 anos, a Centene tem se dedicado a transformar a saúde das comunidades, ampliando o acesso a Medicaid, Medicare e ao Health Insurance Marketplace, além de atender comunidades militares por meio do programa TRICARE. Como a maior organização de managed care do Medicaid e participante-chave no Marketplace, a Centene enfatiza a entrega de cuidados de saúde com foco local, combinada a parcerias sólidas com organizações sem fins lucrativos para atender às necessidades únicas de seus membros. A Centene também é comprometida com sustentabilidade corporativa e responsabilidade social, priorizando a gestão ambiental e a governança ética para promover o bem-estar das comunidades que atende.

Descrição

• Lead and direct process improvement activities to create more efficient and streamlined workflows • Shape and execute the organization's digital quality measurement strategy • Lead and collaborate on NCQA Accreditation and/or HEDIS performance • Lead quality improvement aspects of risk adjustment processes for all products • Collaborate with the Medicare STARS team to improve STARS ratings, including HEDIS, CAHPS, and HOS • Oversee provider satisfaction surveys and implement improvement action plans • Research and incorporate best practices into operations • Organize and control activities, methods, and procedures to achieve business objectives • Review and implement new technological tools and processes • Foster team concepts with internal and external constituencies • Present improvement results and ongoing performance measures to senior management • Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines • Lead the strategy, roadmap, testing, validation, and audit readiness for digital quality measurement, HEDIS, and related clinical quality initiatives

🎯 Requisitos

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Bachelor's Degree Nursing, other related field or equivalent experience required • 7+ years of quality management, quality improvement or healthcare operations experience required • Experience with digital quality measurement, HEDIS, ECDS, FHIR, healthcare interoperability, or related quality transformation initiatives highly preferred • Knowledge of audit readiness • Ability to translate clinical requirements into operational and technology solutions • Master's Degree preferred • Certain states may require a formal certification in quality improvement, risk management, or another parallel field • Current state's RN license preferred • Certified Professional in Health Care Quality preferred

🏖️ Benefícios

• Competitive pay • Health insurance • 401K • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity

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