Clinical Quality Coordinator, RN

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🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $56.2k - $101k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

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

• Educate members about needed screenings, including diabetic and breast cancer screenings • Encourage members to schedule appointments and assist with scheduling as needed • Complete assessments, including the Conditions of Older Adults assessment • Conduct member outreach, provider outreach, and chart review to support HEDIS care gap closure • Coordinate services between PCPs, specialists, medical providers, and non-medical staff • Provide patient and provider education • Facilitate member access to community-based services • Identify and report risk management quality concerns • Support direct care gap closure through member outreach, assessment, and documentation • Provide clinical support to outreach coordinators working with high-risk members and/or providers • Support quality initiatives and outreach to noncompliant members • Maintain a caseload and educate members/guardians through care gap closure activities • Adapt to changing outreach campaigns, priorities, and processes • Perform other duties as assigned

🎯 Requirements

• Bachelor's Degree Nursing required • 2+ years Clinical Nursing in an acute care setting required • 1+ years Case management or quality improvement in a managed care setting required • RN - Registered Nurse - State Licensure and/or Compact State Licensure required • Master's Degree Nursing preferred • Experience in a government sponsored managed care program preferred • Ability to work from home in the Eastern or Central time zone • Approximately 8:00 a.m.–5:00 p.m., with adjustments based on your time zone and business needs • Complies with all policies and standards

🏖️ Benefits

• 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