Behavioral Health HEDIS Specialist (Remote)

Centene Corporation; United States; Hybrid; USD 56,000 - 101,000; Full time

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Flexible work schedules

Job summary

Centene Corporation in the United States seeks a Behavioral Health HEDIS and P4P Navigator to supervise interventions and partner with health plans and regional clinical leadership to raise HEDIS scores in behavioral health. Ideal candidate holds a nursing-related degree and 3+ years in case/utilization management within behavioral/physical health, with HEDIS knowledge and leadership experience.

Centene offers flexible work arrangements (remote, hybrid, field or office), competitive pay and

Qualifications

• Bachelor’s degree in nursing, related field, or equivalent experience.
• 3+ years of experience in case and/or utilization management in behavioral health or physical health care settings.
• Knowledge of behavioral or physical health related HEDIS & performance measures required, supervisory/lead experience preferred.

Responsibilities

• Develop and implement strategies to improve compliance with behavioral health HEDIS metrics and Pay for Performance measures.
• Prepare and present financial impact and ROI on initiatives requiring funding or resources.
• Act as liaison with quality improvement, health plan medical management and other departments on interventions and outcomes.
• Monitor effectiveness of new and existing P4P and HEDIS initiatives and ensure education for members in these measures.
• Analyze data to identify trends and opportunities for quality and clinical improvement.
• Perform other duties as assigned and comply with policies and standards.

Skills

HEDIS improvement

Data analysis

Stakeholder collaboration

Project coordination

Education

Bachelor’s degree in nursing or related field

Job description

Centene Corporation in the United States seeks a Behavioral Health HEDIS and P4P Navigator to supervise interventions and partner with health plans and regional clinical leadership to raise HEDIS scores in behavioral health. Ideal candidate holds a nursing-related degree and 3+ years in case/utilization management within behavioral/physical health, with HEDIS knowledge and leadership experience.

Centene offers flexible work arrangements (remote, hybrid, field or office), competitive pay and