Senior Manager, Quality Improvement, HEDIS Audit

🔥 13 hours ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $107.7k - $199.3k / year

⏰ Full Time

🟠 Senior

👔 Manager

👻 Ghost score 0%

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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

• Provide leadership and direction for continuous quality improvement initiatives • Improve efficiency, processes, quality of care, and services • Provide and analyze reports to identify trends and opportunities • Lead national HEDIS audit and submission activities, including Measure Specifics, HOQ, IDSS, PLD, XML, benchmarking, and final submission • Coordinate company-wide quality assessment and improvement activities • Oversee and coordinate annual file audits and other quality-related initiatives • Manage and implement work tools, processes, reports, and audit tools • Recommend quality improvement opportunities and develop and implement solutions with management, the Quality Improvement Committee, and other committees • Provide feedback to rectify errors and prevent further inconsistencies • Oversee monthly and quarterly reports and data to identify trends, improvement opportunities, and interventions • Maintain policies and operating procedures aligned with internal and external guidelines

🎯 Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Strong HEDIS audit and submission experience highly preferred • Bachelor’s degree in Business, Healthcare, or related field • 5+ years of quality management experience or equivalent leadership experience • Previous experience as lead in a functional area • Experience managing cross-functional teams on large-scale projects or supervisory experience including hiring, training, assigning work, and managing staff • Master's degree preferred

🏖️ Benefits

• Competitive pay • Health insurance • 401K • 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