Director, Quality Improvement

You could be the one who changes everything for our 26million 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 Purpose: Lead and direct process improvement activities that provide more efficient and streamlined workflow.Responsible for leading and collaborating with others on National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performanceResponsible for quality improvement aspects of risk adjustment processes for all productsCollaborate with Medicare STARS team to improve overall STARS ratings for Medicare products (including HEDIS, CAHPS, HOS)Oversee provider satisfaction surveys and implement action plans for improvementsResearch and incorporate best practices into operationsOrganize and control activities, methods, and procedures to achieve business objectivesReview and implement new technological tools and processes and fosters team concept with internal and external constituenciesPresent results of improvement efforts and ongoing performance measures to senior managementFormulate and establish policies, operating procedures, and goals in compliance with internal and external guidelinesOur Comprehensive Benefits Package:Flexible work solutions including remote options, hybrid work schedules and dress flexibilityCompetitive payPaid Time Off including paid holidaysHealth insurance coverage for you and dependents401(k) and stock purchase plansTuition reimbursement and best-in-class training and development Bachelor''s degree in Nursing, related clinical degree or equivalent experience. 7+ years of quality management, quality improvement or healthcare operations experience. Masters'' degree preferred.License/Certificates: Certain states may require a formal certification in quality improvement, risk management, or another parallel field. Current state''s RN license preferred. 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.

Created: 2025-11-15