Quality Improvement Coordinator II – Clinical

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🔥 3 minutes ago

🎰 Nevada – Remote

🎰 Nevada – Remote

💵 $33 - $60 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.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

• Coordinate and monitor quality improvement and organizational projects from inception to closure • Develop and implement quality improvement programs and initiatives at corporate and individual health plan levels • Assist with plan compliance to NCQA/URAC standards • Maintain Quality Improvement policies and procedures in compliance with NCQA/URAC requirements • Identify best practices, research new processes and recommend program enhancements • Support the project life cycle, including requirements gathering, project plans and schedules, resource management, execution, deployment and closure • Assist with collection and presentation of data for identified quality improvement projects • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• Candidate must live in NV • Bachelor’s degree in Nursing or related medical field preferred • 3+ years clinical experience • 1+ years of experience in a quality function • Hands-on experience writing and implementing policies and procedures to support NCQA/URAC or JCAHO accreditation standards preferred • Basic understanding of health insurance business, claims payment procedures, strategies and trends in health care preferred • RN, LPN or LVN • Current state nursing license • Valid driver’s license • CPHQ preferred • Knowledge of NCQA, URAC and State requirements

🏖️ 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

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