HEDIS Quality Improvement Advisor

Centene Corporation; Las Vegas (NV); Sur place; USD 37 000 - 67 000; Plein temps

Résumé du poste

Centene Corporation seeks a Provider Quality & HEDIS Specialist in Nevada to educate and support provider practices on NCQA HEDIS measures and risk adjustment. You will collect and analyze performance data, identify improvement opportunities, and coordinate with Provider Relations to close gaps.

The role requires a Bachelor's degree or equivalent and 3+ years in HEDIS data collection and coding. Up to 75% travel to provider offices is expected.

Qualifications

• Bachelor's degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• Must reside in Nevada and be willing to travel up to 75% to provider offices.

Responsabilités

• Educates providers and IPAs on NCQA HEDIS measures, medical record documentation, and coding.
• Collects, summarizes, trends, and reports provider quality and risk adjustment data for improvement.
• Collaborates with Provider Relations to improve provider performance in Quality, Risk Adjustment and Operations.
• Supports development and implementation of quality improvement interventions and audits.
• Travel up to 75% to provider offices to perform duties.

Connaissances

HEDIS

Risk Adjustment

Provider Education

Coding

Formation

Bachelor's degree or equivalent

Description du poste

Centene Corporation seeks a Provider Quality & HEDIS Specialist in Nevada to educate and support provider practices on NCQA HEDIS measures and risk adjustment. You will collect and analyze performance data, identify improvement opportunities, and coordinate with Provider Relations to close gaps.

The role requires a Bachelor's degree or equivalent and 3+ years in HEDIS data collection and coding. Up to 75% travel to provider offices is expected.