Quality Program Strategist II

🕒 September 16

🐊 Florida – Remote

🐊 Florida – Remote

💵 $70.1k - $126.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 24%

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

• Identify market trends and oversee quality improvement program functions for HEDIS, CAHPS, and/or HOS strategy • Assist stakeholders in determining business issues and recommend solutions that drive business value • Analyze stakeholder business issues, formulate hypotheses, and test conclusions • Conduct evaluations for HEDIS gap closure, CAHPS and/or HOS performance, pilot programs, and process improvements • Evaluate measure technical specifications, performance trends, stakeholders, industry/research literature, organizational initiatives, policies, procedures, and resources/tools • Leverage data analysis to derive actionable insights and strategic recommendations • Collaborate with markets and key business stakeholders to improve measure performance • Develop HEDIS, CAHPS, and/or HOS support resources and tools • Assess health plan needs and collaborate with cross-functional teams on strategic initiatives • Monitor compliance with state reporting, HHS and HPMS memos for quality ratings • Establish quality-check policies and procedures for member and provider communications • Establish QPS policies, procedures, and quality checks for recurring departmental programs and activities • Create, maintain, and facilitate training for Quality Improvement Health Plan staff • Perform other duties as assigned

🎯 Requirements

• Must reside in the state of Florida • Bachelor’s degree in Nursing, Public Health, related field, or equivalent experience • 4+ years of clinical experience, managed care or health insurance experience required • Experience with multiple lines of business • Experience with Five Why's and/or Fishbone • Registered Nurse (RN), Licensed Practical Nurse, Licensed Vocational Nurse or Licensed Clinical Social Worker (LCSW) preferred • CPHQ preferred • Master’s degree preferred • 2+ years of quality experience preferred • Knowledge of HEDIS, CAHPS, and/or HOS quality improvement activities and strategy • Must comply with all policies and standards

🏖️ 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 employment • Consideration of qualified applicants with arrest or conviction records in accordance with applicable law

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