FreshRemote.Work

Quality Improvement Coordinator I

Remote-MS, United States

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.

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: $26.50 - $47.59 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.  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

Apply

Job Profile

Regions

North America

Countries

United States

Restrictions

Field or office work options Holidays Hybrid work possible LA Remote work flexibility

Benefits/Perks

401(k) Competitive benefits Competitive pay Comprehensive benefits Comprehensive benefits package Flexible approach Flexible work options Health insurance Holidays Paid Time Off Stock purchase Stock purchase plans Tuition reimbursement Workplace flexibility

Tasks
  • Analyze
  • Audit medical records
  • Develop
  • Develop and monitor quality improvement initiatives
  • Investigate member complaints
  • Monitor performance
  • Monitor performance measures
  • Oversee reporting and data collection
  • Prepare committee materials
  • Reporting
  • Support quality assurance programs
Skills

Access Audit Benefits Clinical Clinical Quality Clinical quality improvement Data Collection Education Flexibility Health care Healthcare Healthcare quality Health Insurance HEDIS Insurance Investigation Management Medical Records Nursing Performance Improvement Quality Assurance Quality improvement Quality Management Quality of care Reporting Risk Management RN Utilization Utilization management

Experience

2+ years

Education

AS Bachelor Bachelor’s Degree in Nursing Degree in nursing Education Healthcare Health Care Insurance LPN LVN Management Nursing RN

Certifications

Certification Certified Professional in Healthcare LCSW LPN LVN Pa RN

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9