Director, Provider Quality

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🔥 23 hours ago

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Lead and direct process improvement activities that provide more efficient and streamlined workflow • Responsible for leading and collaborating with others on NCQA Accreditation and/or HEDIS performance • Responsible for quality improvement aspects of risk adjustment processes for all products • Collaborate with Medicare STARS team to improve overall STARS ratings • Oversee provider satisfaction surveys and implement action plans for improvements • 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 • Present results of improvement efforts and ongoing performance measures to senior management • Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines

🎯 Requirements

• Bachelor's Degree Nursing, other related field or equivalent experience required • Master's Degree preferred • 7+ years of quality management, quality improvement or healthcare operations experience required • Certified Professional in Health Care Quality preferred

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules