Quality Program Strategist II

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.

***POSITION IS REMOTE***

Position Purpose: Identify market trends and oversee functions of quality improvement programs for HEDIS, CAHPS, and/or HOS strategy and related quality improvement activities. Assists stakeholders to determine their business issues and recommend solutions to drive business value. Analyze stakeholder business issues, formulate hypotheses and test conclusions to determine appropriate solutions.

• Support performance analysis related to CAHPS and HOS measures (including HEI considerations), identifying trends, patterns, and areas for improvement.
• Serve as the primary liaison across assigned health plans between the Enterprise Quality team and local health plan teams for both CAHPS and HOS strategies
• Conduct evaluations to assist with HEDIS gap closure, CAHPS and/or HOS performance and assess for potential pilot programs and/or process improvements to achieve sustainable quality performance goals.

• Conduct ongoing assessment to determine health plan needs, collaborating with cross-functional teams to ensure successful end to end execution of strategic initiative .

• Leverage data analysis to derive actionable insights and strategic recommendations for performance improvements.

• Collaborate and provide support to markets & key business stakeholders to drive continued measure performance.

• Develop HEDIS, CAHPS, and/or HOS support resources and tools to foster gap closure & improve experience for members and providers.

• Conduct ongoing assessment to determine health plan needs, collaborating with cross-functional teams to ensure successful end to end execution of strategic initiatives.

• Monitor and ensure compliance related to state reporting, HHS and HPMS memos for quality ratings.

• Establish quality check policy/procedures for all member and provider communications to ensure accuracy of information, data, and alignment with Centene business goals.

• Establish QPS policies, procedures, and quality checks for all reoccurring departmental programs/activities, to ensure precision execution and accuracy.

• Create, maintain and facilitate training for Quality Improvement Health Plan staff as applicable to assigned responsibility.
• This role may require up to 15% of travel by plane or car for in-person meetings with health plans and quality teams.
• Complies with all policies and standards

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