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Vice President, Quality & Risk Adjustment Process Improvement

Company: Centene Corporation
Location: Raleigh
Posted on: September 13, 2020

Job Description:

Job Description - Vice President, Quality & Risk Adjustment Process Improvement (1194211)

Vice President, Quality & Risk Adjustment Process Improvement

Position Purpose:

Responsible for driving provider performance improvement for HEDIS, Stars, State Contract Quality & Pay for Performance/Withhold, Marketplace QRS and Medicare Quality metrics and Risk Adjustment.

Oversee the development and implementation of enterprise wide and market specific process improvement programs related to Quality and Risk Adjustment

Review and present results of quality & Risk Adjustment interventions for clinical and operational performance improvements and identify organizational risks to executive management

Develop and ensure consistent, reliable and valid application of data collection for HEDIS & Risk Adjustment,

Review and analyze cost benefit and return on investment analyses for organizational resource allocation and recommend action plans

Perform other duties as assigned

Develop and oversee enterprise quality and Risk Adjustment improvement programs and strategies for the business unit. Assist in the development and application of the business unit’s strategic mission and vision. Identify and champion the selection of process improvement activities across the enterprise

Education/Experience:

• Bachelor’s Degree in healthcare or a related clinical field is required

• Minimum of 10 years related experience is required

• Minimum of 3+ years of supervisory/management experience is required

• Experience in Healthcare Operations, including: quality, risk adjustment or process improvement experience is required.

• Experience with the analysis of HEDIS and/or Risk Adjustment performance measures is required

• Up to 15% of travel time will be required

License/Certification:

N/A

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.

Job Quality Assurance

Primary Location USA-Missouri-Clayton

Organization Corporate

Schedule Full-time

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 carrers website. from recruitment fraud. Learn how to protect yourself

Keywords: Centene Corporation, Raleigh , Vice President, Quality & Risk Adjustment Process Improvement, Other , Raleigh, North Carolina

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