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Director, Quality Improvement – Digital Quality Measurement
Centene Corporation. Lead and direct process improvement activities to create more efficient and streamlined workflows .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in leading quality improvement initiatives, digital quality measurement, and healthcare operations, with a strong focus on HEDIS and NCQA Accreditation. Proven ability to translate clinical requirements into effective operational and technological solutions while ensuring compliance with guidelines.
Highest-signal resume keywords
Quality ManagementDigital Quality MeasurementHEDISHealthcare OperationsAudit Readiness
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Process ImprovementQuality ImprovementHealthcare InteroperabilityRisk AdjustmentClinical Quality InitiativesData AnalysisPolicy FormulationOperational ProceduresPerformance MeasurementBest Practices Research
Soft Skills
CollaborationLeadershipCommunicationTeam BuildingPresentation Skills
Tools & Technologies
ECDSFHIRDigital ToolsQuality Measurement ToolsSurvey Implementation
Certifications & Qualifications
RN LicenseCertified Professional in Health Care QualityQuality Improvement CertificationRisk Management Certification
Industry Keywords
NCQA AccreditationMedicare STARSHEDIS PerformanceCAHPSHOS
About the role
Key responsibilities & impact- Lead and direct process improvement activities to create more efficient and streamlined workflows
- Shape and execute the organization's digital quality measurement strategy
- Lead and collaborate on NCQA Accreditation and/or HEDIS performance
- Lead quality improvement aspects of risk adjustment processes for all products
- Collaborate with the Medicare STARS team to improve STARS ratings, including HEDIS, CAHPS, and HOS
- Oversee provider satisfaction surveys and implement improvement action plans
- Research and incorporate best practices into operations
- Organize and control activities, methods, and procedures to achieve business objectives
- Review and implement new technological tools and processes
- Foster team concepts with internal and external constituencies
- Present improvement results and ongoing performance measures to senior management
- Formulate and establish policies, operating procedures, and goals in compliance with internal and external guidelines
- Lead the strategy, roadmap, testing, validation, and audit readiness for digital quality measurement, HEDIS, and related clinical quality initiatives
Requirements
What you’ll need- Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
- Bachelor's Degree Nursing, other related field or equivalent experience required
- 7+ years of quality management, quality improvement or healthcare operations experience required
- Experience with digital quality measurement, HEDIS, ECDS, FHIR, healthcare interoperability, or related quality transformation initiatives highly preferred
- Knowledge of audit readiness
- Ability to translate clinical requirements into operational and technology solutions
- Master's Degree preferred
- 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
Benefits
Comp & perks- Competitive pay
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
- Equal opportunity employer committed to diversity