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.
Prepare Quality Improvement (QI) reports and submit for review
prior to submission.
Track incident, accident, and death (IAD) reports and correspond
to QOC investigations to ensure resolution meets the timeliness
standards and ensure appropriate information is provided the
Organize and assemble IAD and QOC data for the QM Committee, the
Credentialing Committee, and other entities.
Ensure that all departments submit reports timely to the
Participate in the Risk Committee or other appropriate
committees as designated.
Conduct audits of the State IAD-QOC database to ensure data
integrity and timeliness of portal submissions.
Prepare provider financial sanctions for review prior to
Serve as primary point of contact to resolve provider issues
regarding IADs and QOCs.
Education/Experience: High school diploma or equivalent. 2 years
of experience in a health care setting that includes coordination
of member care through physicians, clinical nurses and office
managers. In depth knowledge of medical/mental health terminology
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.