Quality Program Development Manager

Centene Corporation

. Collaborate with Quality, Health Services and Operations business owners or cross-functional work groups to develop and implement standards, policies, procedures, workflows, and decision support systems .

Posted 9/16/2026full-timeRemote • Illinois • United StatesMid-LevelSenior💰 $70,100 - $126,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in program development and management within healthcare, focusing on quality improvement initiatives, regulatory compliance, and cross-functional collaboration. Proficient in utilizing data analytics to enhance patient care and operational efficiency.

Highest-signal resume keywords

Program DevelopmentProject ManagementQuality ImprovementHealthcare ComplianceData Analytics

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Program ManagementProject ManagementQuality ImprovementRoot Cause AnalysisNeeds AssessmentPerformance Improvement ProjectsIntegration of CarePopulation Health ManagementContractual ReviewsQuality Standards Implementation

Soft Skills

CollaborationCommunicationFacilitationLeadershipAnalytical Thinking

Tools & Technologies

Decision Support SystemsQuality Analytics ToolsReporting ToolsWorkflow Management Systems

Certifications & Qualifications

Six Sigma CertificationLean CertificationCertified Professional in Healthcare Quality (CPHQ)

Industry Keywords

Managed CareUtilization ManagementCare CoordinationDisease ManagementMedicareMedicaidDual EligiblesPCMHSTARSHEDIS

About the role

Key responsibilities & impact

Collaborate with Quality, Health Services and Operations business owners or cross-functional work groups to develop and implement standards, policies, procedures, workflows, and decision support systems
Oversee creation and implementation of programs supporting strategic initiatives in Health Services, clinical quality, and operational quality administration
Design and facilitate programs, systems, workflows, and integration efforts aligned with corporate, market, contractual, regulatory, and quality requirements
Serve as content and technical subject matter expert to operations managers and directors
Develop detailed work plans, facilitate root cause analysis, identify and socialize process enhancements, set deadlines, assign responsibilities, and monitor and summarize project progress
Lead state-required Performance Improvement Projects (PIPs), including topic selection, root cause analysis, implementation, and final submission
Conduct needs assessments and ensure program teams and external stakeholders receive information timely
Partner with Quality Analytics and Improvement Teams to determine data needs and assist in designing tools and reports
Consult with clinical and operations staff and provide analysis services for patient quality-of-care improvement initiatives
Conduct other responsibilities and duties as assigned
Comply with all policies and standards

Requirements

What you’ll need

A Bachelor's Degree in a related field required
Equivalent work experience in Business, HC Management, or Nursing accepted
5+ years of experience in direct program development, program management, and/or project management, preferably in a healthcare environment
3+ years of experience in managed care, plus utilization management, care coordination, disease management, Medicare, Medicaid, DSNP, dual eligibles, PCMH
2+ years of experience designing, developing, and implementing STARS, CAHPS, HEDIS and other enterprise quality-related programs
Experience defining eligible populations, service mix, delivery system configuration and financing
Experience integrating behavioral, clinical, social, and community health care for members with multiple chronic conditions
Experience working with multiple market leaders to coordinate consistent quality initiatives
Experience conducting assessments, contractual reviews, and business plans for new quality improvement programs
Experience integrating innovative approaches to defined programs to improve quality ratings company wide
Six Sigma Certification, Lean Certification, or Certified Professional in Healthcare Quality (CPHQ) 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