Quality Improvement Project Manager

🔥 0 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

💵 $70.1k - $126.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👷‍♀️ Project Manager

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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 • Coordinate Work Plan, team and resources for HEDIS/CAHPS submission to Connector Authority and NCQA • Provide functional and technical knowledge for NCQA/HEDIS across plan departmental staff • Deliver educational sessions to internal staff and external constituents as needed • Analyze data and develop presentations, committee materials, newsletter articles and educational pieces • Design, run and manage the data review process to ensure accuracy and integrity of data reports • Coordinate and implement interventions to increase HEDIS, CAHPS and designated health measures • Adhere to NCQA standards and support maintenance of the Plan’s NCQA accreditation • Support coordination of corporate compliance and external surveys • Monitor creation of project deliverables, including design documents, test plans and operations documentation • Support the project life cycle through requirements gathering, project planning, scheduling, resource management, HEDIS audit support, execution, deployment and closure • Coordinate data pulls and ongoing data management for HEDIS and QI project management databases • Evaluate alternative data-capture sources and assess ongoing methodology and results • Maintain detailed project documentation, including meeting minutes, action items, issues lists and risk management plans

🎯 Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Qualified candidates must reside in the state of Florida • Registered Nurse (RN), Licensed Practical Nurse, Licensed Clinical Social Worker (LCSW) or CPHQ certification highly preferred • Bachelor’s degree in Healthcare, Business or equivalent experience • Master’s in Public Health or related field preferred • 4+ years of quality improvement or project management experience in managed care • Advanced knowledge of HEDIS and NCQA • Proficiency required in Microsoft applications including PowerPoint, Excel and Access

🏖️ 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