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MANAGER, QUALITY IMPROVEMENT
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**Position Purpose:** + Oversee and manage the functions of the quality improvement program. Providing support to staff and communicate with departments and staff to facilitate daily quality improvement (QI) functions. + Review and analyze reports,...
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From Centene Corporation
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Date
2021-04-02
Company
Centene Corporation
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Location
Columbus, OH
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About the job:
**Position Purpose:** + Oversee and manage the functions of the quality improvement program. Providing support to staff and communicate with departments and staff to facilitate daily quality improvement (QI) functions. + Review and analyze reports, records and directives. + Confer with staff to obtain data such as new projects, status of work in progress, and problems encountered, required for planning work function activities. Verify data to be submitted in accordance with government program requirements and ensure compliance with state, federal and certification requirements. + Prepare...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Quality Control Systems Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
3

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Data Analyst III (Pharmacy)
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" Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. Provide advanced analytical support for business operations in all or some of the following...
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From Centene Corporation
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Date
2021-03-31
Company
Centene Corporation
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Location
Columbus, OH
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About the job:
" Position Purpose: Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting Extract, load, model, and reconcile large amounts of data across multiple system platforms and sources Review data to determine operational impacts and needed actions; elevate issues, trends, areas for improvement and opportunities to management. Develop reports...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Salary:
Six Figure Jobs (more than $100K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
4

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Data Analyst III
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**Required:** + SQL experience + Power BI, Microstrategy, Tableau - highly preferred + HEDIS experience - highly preferred + Managed Care experience. Prefer experience within a health plan. **Position Purpose:** Responsible for analytic data needs...
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From Centene Corporation
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Date
2021-03-31
Company
Centene Corporation
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Location
Columbus, OH
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About the job:
**Required:** + SQL experience + Power BI, Microstrategy, Tableau - highly preferred + HEDIS experience - highly preferred + Managed Care experience. Prefer experience within a health plan. **Position Purpose:** Responsible for analytic data needs of the business unit. Handle complex data projects and acts as a lead for other Data Analysts. + Provide advanced analytical support for business operations in all or some of the following areas: claims, provider data, member data, clinical data, HEDIS, pharmacy, external reporting + Extract, load, model, and reconcile large amounts of data across...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Computer Systems Analysts
Salary:
Six Figure Jobs (more than $100K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
N/A
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
4

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Risk Adjustment Coder
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**Position Purpose:** Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Ninth Revision (ICD-9) for CMS risk adjustment purposes. + Codes, abstracts and analyzes inpatient...
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From Centene Corporation
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Date
2021-03-26
Company
Centene Corporation
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Location
Columbus, OH
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About the job:
**Position Purpose:** Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Ninth Revision (ICD-9) for CMS risk adjustment purposes. + Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Ninth Revision (ICD-9). Always coding to the highest level of specificity. + Follows the Official ICD-9 guidelines for Coding and Reporting and has a complete understanding of these guidelines. + Follows CMS risk adjustment guidelines and has a complete understanding of...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical Records and Health Information Technicians
Salary:
Middle Income Jobs ($30K-$49K)
Career Level/Education:
Postsecondary nondegree award
Certifications/Licenses:
Certified Coding Specialist
Certified Professional Coder
ICD-10 / ICD-9
Preferred WorkKeys®
Applied Math
3
Graphic Literacy
4
Workplace Documents
4

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Provider Quality Liaison
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Position Purpose: Organize and assemble various quality indicators which are reported to the Quality Management Risk Management Committee. Coordinate Quality of Care (QOC) tracking process and the operational department reporting to ensure timely...
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From Centene Corporation
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Date
2021-03-23
Company
Centene Corporation
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Location
Columbus, OH
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About the job:
Position Purpose: Organize and assemble various quality indicators which are reported to the Quality Management Risk Management Committee. Coordinate Quality of Care (QOC) tracking process and the operational department reporting to ensure timely submission to the payors. - Alignment with Provider Engagement Lead. - Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality and Operations. - Frequent communication with the PE Lead regarding the account management approach of providers for alignment. - Assists in resolving barriers...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Business Operations Specialists, All Other
Salary:
Upper Middle Income Jobs ($50K-$79K)
Career Level/Education:
High school diploma or equivalent
Certifications/Licenses:
National Committee for Quality Assurance
ICD-10 / ICD-9
Preferred WorkKeys®
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A

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Manager, Utilization Management
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**Position Purpose:** Perform duties to conduct and manage the day to day operations of the utilization management function. Communicate with staff to facilitate daily department functions. + Review analyses of activities, costs, operations and...
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From Centene Corporation
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Date
2021-03-19
Company
Centene Corporation
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Location
Fairlawn, OH
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About the job:
**Position Purpose:** Perform duties to conduct and manage the day to day operations of the utilization management function. Communicate with staff to facilitate daily department functions. + Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives. + Promote compliance with federal and state regulations and contractual agreements. + Develop, implement and maintain compliance, policies and procedures regarding medical utilization management functions. + Develop, implement, and maintain utilization management programs to...
Location:
Fairlawn, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Certified Home Inventory Professional
Certified Registered Nurse
Licensed Clinical Social Worker
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

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CONCURRENT REVIEW NURSE I
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Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews. - Perform onsite review of...
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From Centene Corporation
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Date
2021-03-16
Company
Centene Corporation
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Location
Columbus, OH
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About the job:
Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews. - Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations - Complete medical necessity and level of care reviews for requested services using clinical judgment and refer...
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Salary:
Upper Middle Income Jobs ($50K-$79K)
Career Level/Education:
Associate's degree
Certifications/Licenses:
Licensed Practical Nurse
Certified Registered Nurse
Preferred WorkKeys®
Applied Math
5
Graphic Literacy
4
Workplace Documents
5

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Quality Improvement Coordinator I (Public Health)
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**Position Purpose:** + Analyze, develop, implement and monitor clinical quality improvement initiatives to achieve healthy outcomes. + Perform duties and functions to comply with quality improvement programs according to state requirements. +...
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From Centene Corporation
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Date
2021-03-14
Company
Centene Corporation
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Location
Columbus, OH
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About the job:
**Position Purpose:** + Analyze, develop, implement and monitor clinical quality improvement initiatives to achieve healthy outcomes. + Perform duties and functions to comply with quality improvement programs according to state requirements. + Support Quality Assurance Performance Improvement work plan/initiatives. + Schedule and assist with committee and sub-committee preparation. + Assist in investigation and resolution of member quality of care complaints. + Audit medical records and monitor performance measures for health care risk management, sentinel events and trends....
Location:
Columbus, OH
Job Type:
Full-Time
Permanent
Occupation:
Medical and Health Services Managers
Salary:
High Income Jobs ($80K-$99K)
Career Level/Education:
Bachelor's degree
Certifications/Licenses:
Certified Professional in Healthcare Quality
Licensed Practical Nurse
Licensed Clinical Social Worker
Preferred WorkKeys®
Applied Math
4
Graphic Literacy
4
Workplace Documents
5

Display

Recommended

WorkKeys®

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178192 jobs as of 4/11/2021
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Jobs 1 To 8 of 8 1 of 1 1

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