Senior Director, Accreditation & Quality

Company: Centene Corporation
Location: Joplin
Posted on: June 21, 2022

Job Description:

*Remote Eligibilty -You could be the one who changes everything for our 26 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 Purpose: Responsible for the strategic planning, and development of successful Health Plan accreditation and quality improvement programs.. Develop, implement, and lead a process for ensuring that each Health Plan promotes quality and achieves and maintains accreditation. Establish and implement objectives, policies and strategies to achieve successful accreditation status for the company's health plans and improve clinical and service outcomes (HEDIS). Own the development and expansion of accreditation and quality improvement across the enterprise.

• Design and successfully implement the company's NCQA accreditation program
• Ensure quality improvement strategies to achieve accreditation and improve clinical outcomes (HEDIS). Provide oversight and direction to the corporate quality department
• Develop effective working relationships with NCQA, and other required accrediting organizations, as necessary, including scheduling reviews, participating on work groups to enhance measurement systems and negotiating contracts
• Develop and maintain comprehensive knowledge of all internal and external accreditation resources. Ensure that the company and each Health Plan maintain an up-to-date base of knowledge and ownership of accreditation requirements
• Organize, arrange, and conduct internal company training and orientation or accreditation. Oversee and manage continuity between the development and implementation phases of the process. Develop models and standards to simplify and streamline future development activities
• Promote efficient data management and reporting to ensure compliance and quality improvement for defined clinical and service metrics
• Provide ongoing review and oversight of each Health Plan's accreditation and quality related activities, as necessary, to ensure that each Plan receives and maintains its accreditation
• Define and execute a process to perform, organize and conduct internal assessments and mock audits against accreditation standards
• Collaborate with Health Plan leaders (Regional VPs, CEOs, COOs) and Corporate Chief Medical Officer as necessary to achieve desired results, including advice on Health Plan accreditation team members - ensure executive leadership maintains solid understanding of the issues involved, applicable requirements and due dates
• Participate on Health Plan Quality Improvement CounselOur Comprehensive Benefits Package:
  • Flexible work solutions including remote options, hybrid work schedules and dress flexibility
  • Competitive pay
  • Paid Time Off including paid holidays
  • Health insurance coverage for you and dependents
  • 401(k) and stock purchase plans
  • Tuition reimbursement and best-in-class training and development -
    Education/Experience: Bachelor's degree in Business or related field. Master's degree preferred. 7+ years of experience in a related field. Expert in National Committee of Quality Assurance (NCQA) requirements and other accrediting organizations. Experience in Quality Improvement required. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
    
    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.

Keywords: Centene Corporation, Joplin , Senior Director, Accreditation & Quality, Executive , Joplin, Missouri