Quality Program Strategist II

Centene Corporation

. Identify market trends and oversee quality improvement programs for HEDIS, CAHPS, and/or HOS strategy .

Posted 10/8/2026full-timeRemote • United StatesMid-LevelSenior💰 $70,100 - $126,200 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in quality improvement programs, particularly in HEDIS, CAHPS, and HOS strategies, while leveraging data analysis to drive actionable insights and enhance member experience. Collaborates effectively with stakeholders to assess health plan needs and ensure compliance with quality standards.

Highest-signal resume keywords

HEDIS Quality ImprovementCAHPS Performance AnalysisData Analysis for Strategic RecommendationsClinical Experience in Managed CareRegistered Nurse (RN) or LCSW

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quality Improvement ProgramsData AnalysisStakeholder CollaborationPerformance EvaluationMeasure Technical Specifications

Soft Skills

Problem SolvingCommunicationCollaboration

Tools & Technologies

Quality Check PoliciesTraining Development Tools

Certifications & Qualifications

CPHQRegistered Nurse (RN)Licensed Practical NurseLicensed Vocational NurseLicensed Clinical Social Worker (LCSW)

Industry Keywords

HEDISCAHPSHOSManaged CareHealth Insurance

About the role

Key responsibilities & impact

Identify market trends and oversee quality improvement programs for HEDIS, CAHPS, and/or HOS strategy
Assist stakeholders in determining business issues and recommend solutions to drive business value
Analyze stakeholder business issues, formulate hypotheses, and test conclusions to determine solutions
Conduct evaluations for HEDIS gap closure, CAHPS and/or HOS performance, pilot programs, and process improvements
Evaluate measure technical specifications, performance trends, stakeholders, industry/research literature, organizational initiatives, policies, procedures, and resources/tools
Leverage data analysis to derive actionable insights and strategic recommendations
Collaborate with markets and key business stakeholders to improve measure performance
Develop HEDIS, CAHPS, and/or HOS support resources and tools for gap closure and member/provider experience
Assess health plan needs and collaborate cross-functionally on strategic initiatives
Monitor compliance with state reporting, HHS and HPMS memos for quality ratings
Establish quality check policies and procedures for member and provider communications
Establish QPS policies, procedures, and quality checks for recurring departmental programs and activities
Create, maintain, and facilitate training for Quality Improvement Health Plan staff
Perform other duties as assigned

Requirements

What you’ll need

Bachelor’s degree in Nursing, Public Health, related field, or equivalent experience
4+ years of clinical experience, managed care or health insurance experience required
Experience with member engagement, improving member experience and CAHPS and HOS strongly preferred
2+ years of quality experience preferred
Registered Nurse (RN), Licensed Practical Nurse, Licensed Vocational Nurse or Licensed Clinical Social Worker (LCSW), preferred
CPHQ preferred
Schedule aligned with Eastern Standard Time (EST)
Compliance with all policies and standards

Benefits

Comp & perks

Competitive pay
Health insurance
401K and 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