Quality Improvement Project Manager

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🔥 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, including NCQA and HEDIS preparation • Provide functional and technical knowledge for NCQA/HEDIS across plan departmental staff • Deliver educational sessions to internal staff and external constituents as needed • Coordinate work plans, teams, and resources for HEDIS/CAHPS submissions to Connector Authority and NCQA • Analyze data and develop presentations, committee materials, newsletter articles, and educational pieces • Design, run, and manage data review processes to ensure report accuracy and integrity • 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 corporate compliance coordination and external surveys as needed • Monitor project deliverables for adherence to standards, including design documents, test plans, and operations documentation • Support the project life cycle through requirements gathering, project planning and 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 project documentation, including meeting minutes, action items, issue lists, and risk-management plans

🎯 Requirements

• Must be authorized to work in the U.S. without 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 degree 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 in Microsoft 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