Manager, Quality Improvement Analytics - Pharmacy

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Position Purpose:

Oversee, Manage and develop data necessary to analyze trends over various timeframes to drive pharmacy quality measure improvement. Manage the data mining process and analysis using internally supported database programs. Collaborate with various departments and other key business units to identify areas for process improvement initiatives. Directly use data insights

In this Manager, Quality Improvement Analytics role, you will:

Manage staff to ensure the accuracy and timeliness of data requests

Evaluate reports produced by the Quality Initiative (QI) Department and other various departments for trends and opportunities for improvement

Mange the design of tools and databases to capture and track data, methodologies, findings and analysis and ensure data collection/extractions, analysis and submissions meet regulatory compliance requirements

Monitor data and information to assist QI department staff members in improving Medicare STARS, HEDIS, QRS and other required measures

Research and establish benchmarks and statistics for quality measures

Develop, prepare and present reports on quality programs and issues to both internal and external stakeholders

Evaluate and test new or modified programs and procedures used to verify that QI functions and conforms to established guidelines

Required Education/Experience:

Bachelor's degree in Business, Computer Science, Nursing, or other health care related field.

3+ years of related analytical experience in managed health care, Medicare or Medicaid.

Experience with concepts of information management and an in depth knowledge of medical terminology, coding issues and practices, including ICD-9, CPT4, HCPCS Level II.

Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States. However due to the needs of the business, ideal schedule is CST or EST time zones.Pay Range: $84,300.00 - $151,700.00 per yearCentene 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. Total compensation may also include additional forms of incentives.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.