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Business Area: Administrative & Claims Operations

Job Type: Full time

Position Purpose: Identifies quality performance trends, develops key strategic improvement programs and initiatives, and ensures those programs and initiatives are implemented to impact quality rating system performance.

This is a remote opportunity on the Medicare Quality team. The role also serves as a key partner to Product teams, helping ensure quality and Stars requirements are incorporated into product strategy, benefit design, member engagement solutions, and operational enhancements that improve both member experience and quality outcomes

Medicare Stars experience is highly preferred.

+ Identifies trends within quality data utilizing product scorecards, provider scorecards, and enterprise dashboards to strategically develop programs and initiatives in response to those trends to drive improvement. Programs and initiatives are quality driven but could impact departments across the enterprise.

+ Assists stakeholders to determine the root cause of their business issues and recommend solutions to resolve.

+ Ensures implementation of strategic programs and initiatives alongside key stakeholders to drive improvement in quality rating systems and business value.

+ Performs other duties as assigned.

Education/Experience: Bachelor's degree in Nursing, Public Health, Health Administration, Business Administration, related field, or equivalent experience. 5+ years of experience in healthcare quality, including STARS, QRS, and HPRS

License/Certification: Lean Six Sigma or CPHQ preferredPay Range: $87,700.00 - $157,800.00 per year

At Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

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

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