Quality Program Development Manager
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WFA Digital Insight
As the demand for quality healthcare services continues to rise, companies like Centene Corporation are seeking skilled professionals to drive their quality improvement initiatives. With the global healthcare market expected to reach
1.9 trillion by 2026, the need for experienced program development managers is on the rise. In this role, you'll have the opportunity to make a meaningful impact on the lives of 28 million members. To succeed, you'll need a strong background in healthcare program management and a keen understanding of regulatory compliance. Before applying, consider the importance of a bachelor's degree, at least 5 years of experience in healthcare program management, and a deep understanding of the Indian healthcare landscape.
Job Description
About the Role
The Quality Program Development Manager will play a critical role in driving quality improvement initiatives at Centene Corporation. As a key member of the quality team, you will be responsible for developing and implementing efficient and effective standards, policies, and procedures to support ongoing improvements of clinical and administrative operations. This role will support regulatory and quality improvement initiatives, including coordination of NCQA, PIP, and state compliance deliverables across Medicaid and Medicare lines of business.The ideal candidate will have a strong background in healthcare program management, with at least 5 years of experience in managed care and 3 years of experience designing and implementing quality programs. You will be responsible for leading cross-functional efforts to manage complex deliverables, maintaining audit readiness, and driving data-informed performance improvement.
As a Quality Program Development Manager, you will be part of a dynamic team that is committed to transforming the health of communities, one person at a time. You will have the opportunity to work with a diverse group of professionals who are passionate about delivering high-quality healthcare services.
What You Will Do
- Own regulatory and accreditation deliverables, ensuring on-time submission and sustained audit readiness
- Drive audit readiness by establishing and maintaining scalable documentation, workflows, and submission processes that support compliance and reduce risk
- Leverage performance data to identify gaps, lead root cause analysis, and drive targeted quality improvement initiatives that enhance outcomes
- Oversees the creation and implementation of programs relevant to the organization's strategic initiatives involving Health Services, clinical and operational quality administration
- Design and facilitate the development of various programs/systems, work flows, and integration efforts in alignment with Corporate, market, contractual, regulatory, and quality requirements
- Acts as the content and technical subject matter expert to the operation managers and directors for key project initiatives
- Prepare strategic analysis of potential business and/or operational opportunities in relation to new business, rebids, and QI targets using customized solutions
- Conduct needs assessments and identification to ensure the program teams and other external stakeholders receive information in a timely manner
- Partner with leaders and members of the Quality Analytics and Improvement Teams and determines data needs as well as assists in designing tools and reports as necessary
- Partner with clinical and operations staff with consulting and analysis services to support initiatives intended to achieve breakthrough or incremental process improvement in patient quality of care
What We Are Looking For
- Bachelor's degree or equivalent experience
- At least 5 years of healthcare program or project management experience
- At least 3 years of experience in managed care
- At least 2 years of experience designing and implementing quality programs (e.g., HEDIS, CAHPS, STARS)
- Experience in healthcare regulatory, accreditation, or quality improvement environments
- Strong understanding of healthcare regulatory requirements and accreditation standards
- Excellent project management skills, with the ability to manage multiple projects simultaneously
- Strong analytical and problem-solving skills, with the ability to analyze complex data and develop effective solutions
- Excellent communication and interpersonal skills, with the ability to work effectively with cross-functional teams
Nice to Have
- Experience with quality improvement initiatives in a healthcare setting
- Knowledge of healthcare regulations and accreditation standards
- Experience with data analysis and reporting
- Certification in a related field, such as CPHQ or CQM
Benefits and Perks
- Competitive salary and benefits package
- Opportunity to work with a dynamic and growing company
- Collaborative and supportive work environment
- Professional development opportunities
- Flexible work arrangements, including remote work options
- Comprehensive health insurance package
- Retirement savings plan
- Paid time off and holidays
How to Stand Out
- Be prepared to provide specific examples of your experience with quality improvement initiatives and regulatory compliance.
- Highlight your ability to analyze complex data and develop effective solutions.
- Emphasize your excellent communication and interpersonal skills, with the ability to work effectively with cross-functional teams.
- Consider obtaining certification in a related field, such as CPHQ or CQM, to increase your chances of success.
- Be prepared to discuss your experience with project management and your ability to manage multiple projects simultaneously.
- Show a deep understanding of the Indian healthcare landscape and the regulatory requirements that apply to this role.
- Be prepared to provide examples of your ability to drive data-informed performance improvement and your experience with quality improvement initiatives in a healthcare setting.
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