Quality Management Associate at Centene

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

**This position is open to candidates in the state of Texas and services McAllen, TX**

Position Purpose: Responsible for Medical Record retrieval projects; provides clerical support to the department; targets member and provider outreach. Utilize departmental tracking tools to request and retrieve Medical Records; transcribe, format, input, edit, retrieve, copy, and transmit text and data. Store and retrieve files in accordance with established procedures to ensure the timely access of information and records; distribute files as determined by project needs in accordance with the Supervisor and Team Lead. Outreach to members and Providers via telephone or other method of correspondence to assure care needs are being met and all applicable data is received.

Responsible for all aspects of medical record retrieval projects.
Outreach to providers to request medical records. Manage provider expectations. Work with other departments to engage providers and track requests.
Conduct onsite medical record retrievals at provider offices; travel required.
Manage access to electronic health records through each provider's specific EHR.
Retrieve medical records electronically through each provider's specific EHR. Receive and manage medical records from providers obtained via other means.
Manage and track invoices for payment requests. Work with other departments to set up provider payments.
Work pended record requests.
Manage incoming mail for the team; travel required.
Work with other departments to setup provider medical record retrievals by a method convenient to the provider.
Store and retrieve files in accordance with established procedures to ensure the timely access of information and records; distribute files as determined by project needs in accordance with the Supervisor and Team Lead.
Proficiency in Microsoft Office: Excel, Word, Access; Lotus Notes; Internet.
Knowledge of various quality programs, including measures associated with HEDIS.
Ability to lead or coordinate projects within own department.
Business Analysis Knowledge: Skilled to work in a fast paced environment.
Must have strong analytical and problem solving skills.
Customer Service: Skilled to communicate with all levels of management, internal and external customers.
Ability to work well as a member of a team or alone.
Effective Business Communication: Skilled in communicating with technical and business constituencies in writing effective business specifications and requirements.
Performs other duties as assigned.

Complies with all policies and standards

Education/Experience: Associate’s Degree or equivalent experience required. One to two years managed care experience required; knowledge of the industry and terminology. One to two years related experience required.

Pay Range: $15.58 - $26.73 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act