Quality Specialist I

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.
 

**Qualified candidates must reside in the state of Texas**

Position Purpose: Perform quality reviews to ensure high level of customer service and/or accuracy in processing claims and transactions.

• Conduct procedural and quality reviews/audits to ensure adherence to policies and procedures and high levels of customer service, satisfaction and accuracy using applicable tools and technologies

• Provide written documentation to management regarding quality review/audit results

• Collaborate with various cross functional departments to identify training needs, system errors, processing errors, etc. and develop work plans and processes

• Participate in continuous quality improvement initiatives and serve as a resource to others regarding quality concerns

• Analyze data to ensure adjustments/changes yielded anticipated results

• Asist with managing databases, policies and procedures related to assigned areas

• Complete special projects as needed

• 10% travel may be required

• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: High School Diploma or equivalent. 4+ of combined call center/customer service and training/auditing/data analysis experience. Knowledge of insurance or healthcare products and procedures highly preferred. Depending on the state, bi-lingual skills may be preferred.

Pay Range: $19.04 - $32.35 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