质量改进主管，数字质量测量
Director, Quality Improvement, Digital Quality Measurement
职位职责：
领导和指导流程改进活动，实现更高效和简化的流程。这个领导职位将制定并执行组织的数字化质量测量策略，帮助现代化临床质量数据的收集、验证和报告方式。
关键信息：必须已获得在美国工作的合法资格，无需当前或未来任何时间的基于雇佣的签证担保。此职位不提供任何类型的签证担保，包括H-1B、L-1、O-1、H-1B1、F-1、J-1、OPT或CPT。
该职位申请人可以远程在家工作，地点在美国任何地方。
有数字化质量测量、HEDIS、ECDS、FHIR、医疗互操作性或相关质量转型项目经验者优先。理想的候选人应具备战略思维，并了解审计准备，能够将临床需求转化为运营和技术解决方案。
- 负责领导并与其他人员合作进行国家质量保证委员会（NCQA）认证和/或医疗效果数据与信息集（HEDIS）绩效
- 负责所有产品风险调整流程的质量改进方面
- 与Medicare STARS团队合作，提高Medicare产品的整体STARS评分（包括HEDIS、CAHPS、HOS）
- 监督供应商满意度调查并实施改进行动计划
- 研究并整合最佳实践到运营中
- 组织和控制活动、方法和程序以实现业务目标
- 审查并实施新技术工具和流程，与内部和外部利益相关者建立团队理念
- 向高级管理层汇报改进成果和持续的绩效指标
- 制定并建立符合内部和外部指南的政策、操作流程和目标
- 领导数字化质量测量、HEDIS及相关临床质量项目的策略、路线图、测试、验证和审计准备
教育/经验：需要护理学或相关领域的学士学位或同等经验。硕士学历优先。需要7年以上质量管理、质量改进或医疗运营经验
资质/认证：
某些州可能要求获得正式的质量认证
查看英文原文
Position Purpose:
Lead and direct process improvement activities that provide more efficient and streamlined workflow. This leadership role will shape and execute the organization’s digital quality measurement strategy, helping modernize how clinical quality data is collected, validated, and reported.
Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.
Applicants for this job have the flexibility to work remote from home anywhere in the United States.
Experience with digital quality measurement, HEDIS, ECDS, FHIR, healthcare interoperability, or related quality transformation initiatives highly preferred. The ideal candidate will combine strategic thinking with knowledge of audit readiness and the ability to translate clinical requirements into operational and technology solutions.
- Responsible for leading and collaborating with others on National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance
- Responsible for quality improvement aspects of risk adjustment processes for all products
- Collaborate with Medicare STARS team to improve overall STARS ratings for Medicare products (including HEDIS, CAHPS, HOS)
- Oversee provider satisfaction surveys and implement action plans for improvements
- 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 and fosters team concept with internal and external constituencies
- Present results of improvement efforts 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
Education/Experience: Bachelor's Degree Nursing, other related field or equivalent experience required. Master's Degree preferred. 7+ years of quality management, quality improvement or healthcare operations experience required
Licenses/Certifications:
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
Pay Range: $107,700.00 - $199,300.00 per year
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Originally posted on Himalayas