Field-Based HEDIS Quality & Risk Advisor

Centene Corporation; Central City (KY); Ibrido; USD 37.000 - 67.000; Tempo pieno

Descrizione del lavoro

Centene Corporation is seeking a quality-focused professional to educate and support large physician practices and IPAs on HEDIS measures and risk adjustment. You will educate on medical record documentation and coding aligned with NCQA requirements, and collaborate to close gaps in provider performance.

The role requires up to 75% travel to provider sites, with ongoing data collection and trend analysis to drive improvements across quality and risk adjustment.

Competenze

• Bachelor's Degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding).
• Willingness to travel up to 75% to provider offices.
• Licenses/Certifications include RHIT or equivalent as listed by Centene. For KY plan, additional licenses preferred but not required.

Mansioni

• Delivers, advises and educates provider practices and IPAs in HEDIS measures, documentation guidelines and coding per NCQA requirements.
• Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify improvement opportunities.
• Collaborates with Provider Relations and other provider-facing teams to improve Quality, Risk Adjustment and Operations performance.
• Identifies specific practice needs where Centene can provide support.
• Develops, enhances and maintains provider clinical relationships across product lines.
• Maintains Quality KPI and HEDIS abstraction accuracy per corporate standards.
• Travel up to 75% to provider offices and perform other duties as assigned.
• Complies with all policies and standards.

Conoscenze

HEDIS knowledge

Provider education

Risk adjustment coding

Travel readiness

Formazione

Bachelor's degree or equivalent

Descrizione del lavoro

Centene Corporation is seeking a quality-focused professional to educate and support large physician practices and IPAs on HEDIS measures and risk adjustment. You will educate on medical record documentation and coding aligned with NCQA requirements, and collaborate to close gaps in provider performance.

The role requires up to 75% travel to provider sites, with ongoing data collection and trend analysis to drive improvements across quality and risk adjustment.