Centene Corporation · 2 hours ago

Director, Quality Program Strategy

Kenton County, KY

Full-time

Remote

Director/Executive

$114K/yr - $210K/yr

7+ years exp

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Hospitals and Health Care

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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

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Quality ImprovementHEDIS OperationsRisk AdjustmentMedicare StarsHealthcare ExperienceData Capture StrategiesRoot Cause AnalysisQuality Rating SystemsRN License