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.
• Performs other duties as assigned

• Complies with all policies and standards

This is a fully remote role seeking an RN or LPN with experience in quality improvement, specifically identifying and closing HEDIS gaps in care.

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: $27.02 - $48.55 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, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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