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Quality Improvement Coordinator – Behavioral Health
Centene Corporation. Analyze, develop and monitor clinical QI activities to ensure compliance with customer expectations .
Posted 10/28/2026full-timeRemote • Louisiana • United StatesJuniorMid-Level💰 $34 - $61 per hourWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in clinical quality improvement activities, compliance with NCQA and state regulations, and effective management of behavioral health quality programs. Proven ability to lead initiatives, analyze clinical information, and resolve quality of care complaints.
Highest-signal resume keywords
Clinical Quality ImprovementBehavioral Health Quality Program ManagementNCQA ComplianceRegistered Nurse (RN) CertificationQuality Assurance in Healthcare
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical AnalysisQuality Improvement InitiativesBehavioral Health Performance Improvement ProjectsMedical Necessity ReviewProgram EvaluationDocumentation ManagementAppeals PreparationGrievance ResolutionHEDIS MeasuresManaged Care Experience
Soft Skills
LeadershipCommunicationProblem-SolvingCollaborationLiaison Skills
Certifications & Qualifications
Registered Nurse (RN)Licensed Mental Health Professional (LMHC)Licensed Professional Counselor (LPC)
Industry Keywords
Clinical NursingBehavioral HealthcareHealthcare AdministrationQuality AssuranceCompliance Standards
About the role
Key responsibilities & impact- Analyze, develop and monitor clinical QI activities to ensure compliance with customer expectations
- Lead clinical quality initiatives
- Review clinical information for appeals to determine medical necessity of services
- Prepare reviews and cases for appeals and fair hearings
- Develop and implement the behavioral health quality program description, work plan goals, HEDIS measures and program evaluation documents
- Lead Behavioral Health Performance Improvement Projects (PIPs)
- Maintain files, logs and documentation, including communications, in accordance with NCQA and State standards and regulations
- Investigate and resolve behavioral health quality of care complaints and grievances
- Act as liaison for appeals and fair hearings
- Perform other duties as assigned
Requirements
What you’ll need- Associate's Degree in Nursing or other related field of study required
- 2+ years in Clinical Nursing or Behavioral Health required
- 1+ years experience in Quality, Managed Care or Healthcare Administration required
- Experience in Behavioral Healthcare field preferred
- Registered Nurse (RN) certification, Licensed Mental Health Professional (LMHC), or Licensed Professional Counselor (LPC) required
- Compliance with NCQA and State standards and regulations, including timelines
- Must comply with all policies and standards
Benefits
Comp & perks- Competitive pay
- Health insurance
- 401K plan
- 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