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Position Purpose
Assist with the daily operations and support within the Quality Improvement department including data management, data reporting needs, and project management.
Responsibilities
Manage the HEDIS project, including assignment of nurses, adherence to the plan timeline, and vendor oversight for timeliness and quality.
Assist in data collection, data entry, and generation of reports in support of QI initiatives such as access and availability studies, HEDIS abstraction forms, medical records/site reviews, member and physician satisfaction studies.
Analyze data and report writing for committee discussion.
Research and write items for provider newsletters and other educational pieces.
Design, run, and manage the data review process to ensure accuracy and integrity of data reports to meet regulatory and operational requirements.
Implement process improvements to streamline departmental functions.
Assist the Director, QI in preparation for audits by regulatory agencies and review organizations.
Perform other duties as assigned.
Comply with all policies and standards.
Candidate Profile
Candidate in this role will be responsible for writing accreditation reports for NCQA.
Location
This position is open to candidates located in Michigan or other parts of the country. Candidates must be able to work in Eastern Time Zone hours.
Education/Experience
Associate’s degree in a related field or equivalent experience.
4+ years of data management experience in a health insurance organization, with accountability for report generation management or project management.
Working knowledge of MS Office applications.
Experience in quality initiatives (including HEDIS project, study analysis, or NCQA standards) preferred.
Pay Range
$55,100.00 - $99,000.00 per year
Benefits
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.
EEO Statement
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.