All roles

Open role

Quality Improvement Specialist (HEDIS)

Remote · Colombia Full-time

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. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT Position Purpose: Support the development and maintenance of quality improvement related projects specific to HEDIS Hybrid Operations. The position exists to support the health plans in the clinical aspect of medical record review.

  • Train providers, health plans and staff in methodologies and tools of continuous quality improvement and HEDIS abstraction and over-read processes
  • Provide clinical support to the medical record abstraction, over-read and audit processes
  • Monitor performance on established contractual quality indicators.
  • Analyze, track and trend results
  • Prepare for and participate in meetings with various committees, state agencies, providers, health plans, vendors, and stakeholders
  • Recommend, develop, and implement quality performance improvement plans (PIPs) with management utilizing the PDSA model.
  • Monitor and report PIPs progress through closure.
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Bachelor’s degree in Nursing, Healthcare, or Quality (including HEDIS measures or NCQA) or equivalent experience in related healthcare experience. License/Certification: Valid state clinical license preferred (i.e.- LPN, RN, etc.) Pay Range: $56,200.00 - $101,000.00 per year 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 Additional Information Company: Centene Location: Oklahoma Salary: $56,200.00 - $101,000.00 per year Job ID: Specialties: HEDIS, Quality Improvement Required Licenses: RN, LPN/LVN Experience Level: No Experience

More open positions

Remote Life and Health Insurance Agent

Work from home Full-time role

Adjunct Faculty Pool - Fine Arts, Sculpture

Work from home Full-time role

Loan Officer | USA Remote Commission - 2365

Work from home Full-time role

Strategic Remote Civil Engineer - New York State

Work from home Full-time role

Remote Tax Advisor, CPA Firm

Work from home Full-time role

Ingeniero de Calidad de Datos Proficient

Work from home Full-time role

Seasoned Remote Customer Experience Specialist – Empower Brands with Insightful Feedback and Earn Competitive Pay from Home

Work from home Full-time role

Medical Expert, Fertility (Contractor)

Work from home Full-time role

Staff Data Scientist

Work from home Full-time role

Senior Art Director – Fashion

Work from home Full-time role

Vendor Operations Specialist

Work from home Full-time role

Sales Compensation Analyst, Contract

Work from home Full-time role

Human Resources Generalist

Work from home Full-time role

[Remote] Project Manager (5961)

Work from home Full-time role

[Remote] Accountant

Work from home Full-time role

Hindi & Punjabi Music Content Specialist

Work from home Full-time role

Senior Website Project Manager - US & Canada

Work from home Full-time role

Bank Recruiter (1099) – Remote (Rockport, TX) – Job # 3433b

Work from home Full-time role

Telemedicine Physician

Work from home Full-time role

Senior Remote Customer Success Engineer – Advisory Services & Workflow Optimization Specialist – Driving AI‑Powered Audit & Consulting Excellence at brighthush

Work from home Full-time role

Insurance Sales Representative - Remote

Work from home Full-time role