Job Description

Clinical Professional Opportunity: Transforming Healthcare for All

We are seeking compassionate individuals from all walks of life to join our Medical Management/Health Services team. At Centene, a national organization, we believe in the power of diversity and offer competitive benefits along with a fresh approach to workplace flexibility.

Join Us at Oklahoma Complete Health

Oklahoma Complete Health, a Centene company, is dedicated to improving the health of Oklahomans by providing quality healthcare solutions. We are advocates for our community, fostering an inclusive culture that promotes work-life balance, competitive compensation, and continuous career development. Together, we form a collaborative network of innovative thinkers who deliver solutions at the local level.

Your Role: Enhancing Clinical Quality of Care

• Manage and support the development and maintenance of clinical quality of care, related projects, investigations, and reporting.
• Ensure compliance with quality of care standards and reporting requirements set by the State, URAC, and our Quality Management Plan.
• Provide supervision and training for Quality of Care (QOC) Specialists, ensuring accurate and timely processing of QOC data.
• Follow clinical investigation and reporting processes in accordance with State requirements.
• Analyze, track, and report results, developing quality indicator reports for management.
• Collaborate with management to recommend and implement effective quality improvement plans.
• Train providers and staff in continuous quality improvement methodologies and tools.
• Participate in meetings with committees, State agencies, providers, and stakeholders.
• Offer clinical support for medical record audits and quality improvement processes.
• Some travel may be required.

Requirements:

• Residence in Oklahoma is a must.
• Bachelor's degree in a related field; Master's degree preferred.
• 4+ years of behavioral health or quality improvement experience, including 1+ year in physical health.
• 2+ years of clinical supervisory experience preferred.
• License/Certificates: Registered Nurse (RN) required. Certified Professional in Health Care Quality preferred. Current state driver’s license.

Our Comprehensive Benefits Package:

• Flexible work solutions including remote options, hybrid work schedules, and dress flexibility.
• Competitive pay and paid time off, including holidays.
• Health insurance coverage for you and your dependents.
• 401(k) and stock purchase plans.
• Tuition reimbursement and best-in-class training and development programs.

A Diverse and Inclusive Workplace

Centene is proud to be an equal opportunity employer that embraces diversity and values our differences. We believe in providing equal employment opportunities to all qualified applicants, regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics, as required by applicable law.

Please note this is a simplified and inclusive version of the original job ad provided.