HEDIS Quality Advisor & Provider Education Lead

Centene Corporation; Central City (KY); Presencial; USD 37.000 - 67.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401K and stock purchase plans

Tuition reimbursement

Descripción de la vacante

Centene Corporation seeks a HEDIS Quality Improvement Specialist to educate provider practices and IPAs on NCQA HEDIS measures, documentation guidelines, and coding. Travel up to 75% across Kentucky and surrounding areas is required.

You will collect and summarize performance data, work with provider relations, and support quality interventions to close gaps and improve plan performance. A Bachelor’s degree and 3+ years in HEDIS/risk adjustment are required.

Formación

• Bachelor's Degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.

Responsabilidades

• Delivers, advises and educates provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with state, federal, and NCQA requirements.
• Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure.
• Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters).
• Identifies specific practice needs where Centene can provide support.
• Develops, enhances and maintains provider clinical relationship across product lines.
• Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards.

Conocimientos

Travel up to 75%

Educación

Bachelor's Degree or equivalent

3+ years HEDIS record collection & risk adjustment experience

Descripción del empleo

Centene Corporation seeks a HEDIS Quality Improvement Specialist to educate provider practices and IPAs on NCQA HEDIS measures, documentation guidelines, and coding. Travel up to 75% across Kentucky and surrounding areas is required.

You will collect and summarize performance data, work with provider relations, and support quality interventions to close gaps and improve plan performance. A Bachelor’s degree and 3+ years in HEDIS/risk adjustment are required.