HEDIS Quality Advisor — Provider Education & Field Support

Centene Corp.; Corpus Christi (TX); Hybrid; USD 37,000 - 68,000; Full time

Benefits offered by this job

Hybrid work arrangement

Job summary

Centene Corp. in Texas seeks a Health Quality Specialist to educate providers on HEDIS measures, documentation, and coding per NCQA standards. The role focuses on risk adjustment data collection and provider performance improvement.

The position is hybrid, requires travel up to 75%, and candidates must have a Bachelor's degree and 3+ years in HEDIS/risk adjustment. Licenses such as CPC/CPC-A or RN/LVN are highly preferred.

Qualifications

• Bachelor's degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• Licenses/certifications: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS.

Responsibilities

• Delivers and educates provider practices and IPAs on HEDIS measures and coding per NCQA requirements.
• Collects, summarizes, trends and delivers provider quality and risk adjustment performance data.
• Collaborates with Provider Relations to improve provider performance in Quality, Risk Adjustment and Operations.
• Travels to provider offices up to 75% of the time.

Skills

HEDIS knowledge

Provider education

Coding (risk adjustment)

Data analysis

Travel up to 75%

Education

Bachelor's Degree or equivalent

Job description

Centene Corp. in Texas seeks a Health Quality Specialist to educate providers on HEDIS measures, documentation, and coding per NCQA standards. The role focuses on risk adjustment data collection and provider performance improvement.

The position is hybrid, requires travel up to 75%, and candidates must have a Bachelor's degree and 3+ years in HEDIS/risk adjustment. Licenses such as CPC/CPC-A or RN/LVN are highly preferred.