Nashville, Tennessee

Position Purpose:

  • Analyze performance data to evaluate the efficiency and effectiveness of clinical processes
  • Perform quality audits of all clinical functions
  • Work with the clinical business units to develop and implement preventive and/or corrective action plans as needed
  • Performs quality audits of clinical functions
  • Analyzes performance data to evaluate the efficiency and effectiveness of clinical processes
  • Works with clinical business units to develop and implement preventive and/or corrective action to remedy or prevent performance failures
  • Tracks quality improvement activities, assesses trends and provides reporting to various departments and committees
  • Reviews and assesses the documentation used in clinical business units to ensure compliance with the control of documentation requirement
  • Facilitates process improvement in clinical business units

Education/Experience:

Bachelor’s degree in a clinical field. Minimum three years managed care experience.

License/Certification:

RN license. Must have and maintain current, valid and unrestricted Registered Nurse (RN) license. Position requires CPHQ (Certified Professional in Healthcare Quality) certification.

This position is 100% remote.

Government Security/Clearance/Citizenship Requirements: Requires US Citizenship and current security clearance.

This position will be supporting a Federal government contract, therefore it requires U. S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 or higher security.

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.

Nashville, Tennessee

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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