Director, Quality Improvement

🕒 July 2

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $118.4k - $219k / year

⏰ Full Time

🔴 Lead

👔 Director

👻 Ghost score 26%

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

• Lead and direct process improvement activities to create more efficient and streamlined workflows • Lead and collaborate on NCQA Accreditation and/or HEDIS performance • Manage quality improvement aspects of risk adjustment processes for all products • Collaborate with the Medicare STARS team to improve STARS ratings for Medicare products • 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 a team concept 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 guidelines • Perform other duties as assigned and comply with all policies and standards

🎯 Requirements

• Bachelor's Degree in 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 • Experience with HEDIS operations and quality strategy initiatives highly preferred • Ability to lead and collaborate on NCQA Accreditation and/or HEDIS performance • Knowledge of risk adjustment processes for all products • Knowledge of Medicare STARS, including HEDIS, CAHPS, and HOS • Ability to oversee provider satisfaction surveys and implement improvement action plans • Ability to research and incorporate best practices into operations • Ability to review and implement technological tools and processes • Ability to present improvement results and performance measures to senior management • Ability to formulate policies, operating procedures, and goals in compliance with internal and external guidelines

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • 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