Tampa, Florida

Position Purpose:

  • Lead and direct process improvementactivities that provide more efficient and streamlined workflow

  • Responsible for leading andcollaborating with others on National Committee for Quality Assurance (NCQA)Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS)performance

  • Responsible for quality improvementaspects of risk adjustment processes for all products

  • Collaborate with Medicare STARS teamto improve overall STARS ratings for Medicare products (including HEDIS, CAHPS,HOS)

  • Oversee provider satisfactionsurveys and implement action plans for improvements

  • Research and incorporate bestpractices into operations

  • Organize and control activities,methods, and procedures to achieve business objectives

  • Review and implement newtechnological tools and processes and fosters team concept with internal andexternal constituencies

  • Present results of improvementefforts and ongoing performance measures to senior management

  • Formulateand establish policies, operating procedures, and goals in compliance withinternal and external guidelines

Education/Experience: Bachelor's degree in Nursing, related clinical degree or equivalent experience. 7+ years of quality management, quality improvement or healthcare operations experience. Masters’ degree preferred.

License/Certificates: Certain states may require a formal certification in quality improvement, risk management, or another parallel field. Current state’s RN license preferred. Certified Professional in Health Care Quality preferred.

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.

Tampa, Florida

Centene Corporation, a Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, correctional healthcare services, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services.

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