Quality Improvement Coordinator (HEDIS)

Remote Full-time
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:
Analyze, develop, implement and monitor clinical quality improvement initiatives to achieve healthy outcomes.
• Perform duties and functions to comply with quality improvement programs according to state requirements.
• Support Quality Assurance Performance Improvement work plan/initiatives.
• Schedule and assist with committee and sub-committee preparation.
• Assist in investigation and resolution of member quality of care complaints.
• Audit medical records and monitor performance measures for health care risk management, sentinel events and trends.
• For PA H&W only:
• Responsible for overseeing reporting and outcome measurement and HEDIS data collection, serving as point person between the Department and the Department’s EQR contractor.
• Performs other duties as assigned
• Complies with all policies and standards
This is a fully remote role seeking an RN or LPN with experience in quality improvement, specifically identifying and closing HEDIS gaps in care.

Education/Experience:
Bachelor’s degree in nursing preferred. 2+ years clinical, quality management or healthcare related experience. At least one year experience in quality function in a healthcare setting.

License/Certification: LPN, LVN, RN, PA, or LCSW license preferred. Utilization management certification preferred. Certified Professional in Healthcare Quality preferred.
Pay Range: $27.02 - $48.55 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply tot his job

Apply To this Job
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

**Experienced Bilingual Customer Service Associate (Night Shift) – Enterprise Software Support**

Remote Full-time

**Experienced Medical Records Clerk / Data Entry Operator – Remote Healthcare Administration**

Remote Full-time

Associate Quantitative Equity Analyst

Remote Full-time

Experienced Online Data Entry Specialist – Remote Part-Time Opportunity for Detail-Oriented Individuals at blithequark

Remote Full-time

Senior Software Engineer, PubSec

Remote Full-time

Legal Director or Head of Legal Operations – Remote, United States (878-SLS)

Remote Full-time

Experienced Part-Time Remote Data Entry Specialist for Accurate and Efficient Data Management at blithequark

Remote Full-time

Operational Risk Director

Remote Full-time

Behavioral Support Specialist

Remote Full-time

Experienced Direct Support Professional for Day Services - Join PathPoint's Compassionate Team in Santa Maria, CA

Remote Full-time
← Back to Home