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Vice President, Quality Improvement

Company: Centene Corporation
Location: Albuquerque
Posted on: September 17, 2020

Job Description:

Category Quality Location Albuquerque, New Mexico, US Full-time Job Id 1179832 Western Sky Community Care

Position Purpose: Oversee all related activities for the Quality Improvement functions. Lead and direct process improvement activities for more efficient and streamlined workflow. Oversee the business processes related to risk adjustment and quality improvement for assigned products and plans.

Responsible for all activities related to National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance ensuring highest level of accreditation

M anage all aspects of HEDIS improvement activities, including outreach, incentives, data integrity and chart review

Review and implement new technological tools and processes and foster team concept with internal and external constituencies

Present results of improvement efforts and ongoing performance measures and recommend actions plans to senior management

Research and incorporate quality improvement best practices into operations

Organize and control activities, methods, and procedures to achieve business objectives

Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines

Manage and ensure compliance of EPSDT program as well as compliance and turnaround time of grievances and appeals

Education/Experience: Bachelor's degree in Nursing or related clinical field or equivalent experience. Master'sā€™ degree preferred. 10+ years of healthcare operations experience, including quality improvement and NCQA accreditation experience.

Experience managing acquisition and integration of external data sources.

Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

Familiarity with running Risk Adjustment prospective and retrospective programs preferred

License/Certification : RN license and Certified Professional in Health Care Quality preferred.

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.

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Transforming the health of the community, one person at a time.

HEALTHCARE IS BEST DELIVERED LOCALLY Our local approach allows us to help members access high-quality, culturally sensitive healthcare services.

LOCAL COMMUNITY INVOLVEMENT IS KEY We invest in local communities and the lives of our members in as many ways as we can.

Stay safe from recruitment fraud! The only way to apply for a position at Centene is via our careers website. Learn how to protect yourself from recruitment fraud.

Keywords: Centene Corporation, Albuquerque , Vice President, Quality Improvement, Other , Albuquerque, New Mexico

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