Full-Time

Quality Improvement Abstractor

Posted on 1/16/2025

Centene

Centene

10,001+ employees

Provides health insurance and services

Healthcare

Compensation Overview

$26.5 - $47.59Hourly

Mid, Senior

Remote in USA

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Required Skills
Excel/Numbers/Sheets
Requirements
  • Associate’s degree in related field or equivalent experience
  • 4+ years of nursing, medical assistant, medical coding or data management experience
  • Advanced knowledge of Microsoft Applications, including Microsoft Excel and Access
Responsibilities
  • Lead data collection and abstraction for company quality measures, including HEDIS, CMS, CHIPRA and/or any other custom measurements
  • Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards
  • Review medical records and abstract data for HEDIS and other measure sets in compliance with standards
  • Track and report on issues and outcomes related to abstractions and over-reads
  • Communicate outcomes of abstraction and over-sight activities with health plans and vendors when required
  • Perform other quality initiatives as necessary
Desired Qualifications
  • Bachelor degree is preferred
  • Experience in quality initiatives (including HEDIS project, study analysis, or NCQA standards) is preferred
  • Current state’s RN or LPN license is preferred

Centene Corporation operates in the healthcare industry, focusing on improving the health of individuals, especially those who are underinsured or uninsured. The company provides a variety of health insurance products and services, including medical, dental, vision, behavioral health, and pharmacy benefits. Centene's approach is localized, allowing it to tailor its services to meet the specific needs of different communities across the United States. This model helps the company serve a diverse clientele, with 27.5 million members and significant revenue from premium services. Unlike many competitors, Centene emphasizes cost-effective care while maintaining high quality, aiming to enhance health outcomes and manage expenses effectively. Additionally, the company is committed to corporate sustainability, addressing social health barriers, and supporting employee well-being through flexible work arrangements.

Company Stage

IPO

Total Funding

N/A

Headquarters

Saint-Louis, Senegal

Founded

1984

Simplify Jobs

Simplify's Take

What believers are saying

  • Expansion of telehealth services enhances access for underserved populations.
  • ICHRA introduction attracts customers seeking personalized, flexible insurance options.
  • Essential Plan expansion highlights growth potential in low-cost insurance markets.

What critics are saying

  • Increased competition in the Health Insurance Marketplace may impact Centene's market share.
  • Potential regulatory changes in Medicaid and Medicare could affect revenue streams.
  • Economic downturns may decrease premium collections, impacting financial performance.

What makes Centene unique

  • Centene's localized approach tailors healthcare services to specific community needs.
  • The company offers a wide range of health insurance products through local brands.
  • Centene focuses on cost-effective, high-quality care for underinsured and uninsured individuals.

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Benefits

Health Insurance

401(k) Retirement Plan

401(k) Company Match

Paid Vacation

Hybrid Work Options

Flexible Work Hours