Centene Corporation

Transforming the health of the communities we serve, one person at a time.

Director, HEDIS Quality & Process Improvement

Project ManagerProject ManagerFull TimeRemoteTeam 10,001+Since 1984H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

11 days ago

Salary

Not specified

No structured requirement data.

Job Description

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

This position involves leading and directing process improvement initiatives by utilizing process improvement methodologies in the analysis of current operations and design of improvement projects across all areas that impact operations.

  • Accountable for managing the end-to-end NCQA audit timeline and ensuring the organization successfully passes audit each year.
  • Oversee the administration, coordination, and evaluation of quality assurance and training, including policy and procedure development, training assessments, and quality adherence auditing.
  • Direct the execution of performance improvement projects, including process mapping and process design.
  • Create and maintain dashboards, communications, and strategies to improve effectiveness.
  • Research and develop best practices, policies, procedures, and goals in compliance with internal and external guidelines.
  • Oversee data analysis and gathering processes and programs to establish costs and benefits of process effectiveness and efficiency.
  • Ensure business unit is compliant with URAC and Joint Commission Accreditation standards.
  • Review and implement new technological tools and processes.
  • Establish strong collaborative relationships with all functional units and their leaders.

Qualifications

  • Bachelor's Degree in related field.
  • 6+ years of quality and process improvement experience.
  • Healthcare industry experience preferred.
  • Knowledge of research methodologies including measures and outcomes.
  • Knowledge of process mapping, process design, and workflow management software and applications.
  • URAC and Joint Commission Accreditation experience preferred.
  • Deep experience leading end-to-end HEDIS audits and managing NCQA timelines highly preferred.

Requirements

  • Six Sigma/LEAN Certification preferred.

Benefits

  • Competitive pay.
  • Health insurance.
  • 401K and stock purchase plans.
  • Tuition reimbursement.
  • Paid time off plus holidays.
  • Flexible approach to work with remote, hybrid, field, or office work schedules.

Job Requirements

  • Bachelor's Degree in related field.
  • 6+ years of quality and process improvement experience.
  • Healthcare industry experience preferred.
  • Knowledge of research methodologies including measures and outcomes.
  • Knowledge of process mapping, process design, and workflow management software and applications.
  • URAC and Joint Commission Accreditation experience preferred.
  • Deep experience leading end-to-end HEDIS audits and managing NCQA timelines highly preferred.
  • Six Sigma/LEAN Certification preferred.

Benefits

  • Competitive pay.
  • Health insurance.
  • 401K and stock purchase plans.
  • Tuition reimbursement.
  • Paid time off plus holidays.
  • Flexible approach to work with remote, hybrid, field, or office work schedules.

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