Quality and Risk Adjustment Analyst

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: Perform ongoing measurement, analysis, and monitoring of business process and member outcomes data sets. Assist Clinical Engagement team in targeting interventions to improve quality, HEDIS and risk-adjustment outcomes.

• Responsible for analyzing quality and risk adjustment data for the Clinical Engagement Team and preparing reports for leadership
• Design solutions to address quality and risk adjustment issues and improve outcomes
• Assess the quality of the performance through data analysis
• Utilize data to analyze, identify trends and skill gaps, and develop recommendations to management for an optimized member and provider experience
• Assist with adhoc projects and analysis as needed
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: Bachelor's Degree in business or health related field required. Master's Degree in related field preferred. 1+ years advanced knowledge in Microsoft applications, including Excel, Access, and Power BI preferred. Required
1+ years statistical or data analysis experience or 0-1 years of HEDIS data analysis experience including measurement and rates impacted required.

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.  Total compensation may also include additional forms of incentives.

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