Director, Quality Program Strategy jobs in United States
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Centene Corporation ยท 1 month ago

Director, Quality Program Strategy

Centene Corporation is transforming the health of communities across the United States. The Director of Quality Program Strategy will lead and direct the development and management of quality programs and improvement initiatives, ensuring effective execution and compliance with healthcare standards.

Hospital & Health Care

Responsibilities

Oversee aspects of the company quality measure improvement outreach strategy including the execution of function for all markets and products
Direct quality measures portfolio management for all products through development and execution of best practices towards achieving market and product quality and risk goals
Serve as subject matter expert in measure development and methodology
Define business requirements and strategies for data capture to close risk and care gaps
Perform root cause analysis, failure mode, and effective analysis and identify opportunities to mitigate future risks
Plan and direct programs, and initiatives related to HEDIS Stars and quality ratings systems, Medicaid pay for performance, accreditation targets and HOS improvement and gap closure
Communicate risk, organizational impact and progress towards achieving goals to executive leadership
Identify Market and Product strengths, weaknesses, opportunities and threats
Develop work process for supplemental data capture in compliance with HEDIS technical specifications

Qualification

Quality improvementHEDIS operationsRisk AdjustmentMedicare productsQuality rating systemsCommunication skillsLeadership skills

Required

Bachelor's degree in Nursing, related clinical degree or equivalent experience
7+ years of healthcare related experience including quality improvement, HEDIS operations, and Risk Adjustment
Experience with quality rating systems, Medicare products, Medicare Stars, and Marketplace products

Preferred

Experience with PA health plans is highly preferred
Previous experience working in a managed care setting is highly preferred
Current state's RN license preferred

Benefits

Competitive pay
Health insurance
401K and stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules

Company

Centene Corporation

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Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives.

Funding

Current Stage
Late Stage

Leadership Team

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Beth Johnson
President and CEO, Coordinated Care
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Clyde White
President & CEO (New Hampshire Healthy Families)
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Company data provided by crunchbase