HEDIS Quality Improvement Advisor

Centene Management Company LLC; Nevada (IA); Hybrid; USD 37,000 - 67,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

PTO + holidays

Flexible work arrangements

Job summary

Centene Management Company LLC seeks a provider education and quality improvement professional to educate physicians and IPAs on NCQA HEDIS measures and risk adjustment, supporting documentation and coding across plan providers.

This role involves travel up to 75% to provider offices, collaboration with Provider Relations, and ongoing education to improve HEDIS performance and plan compliance with state and federal standards.

Qualifications

• 3+ years experience in HEDIS record collection and risk adjustment (coding).
• Educates providers on NCQA HEDIS measures and risk adjustment.
• Travels up to 75% to provider offices; collaborates with Provider Relations.

Responsibilities

• Deliver provider education on HEDIS measures and documentation guidelines.
• Coach providers on coding (HEDIS ICD-9/10 CPT) and risk adjustment.
• Collaborate with health plan teams to improve provider performance and gap closure.

Skills

HEDIS knowledge

Quality improvement

Provider education

Data analysis

Risk adjustment understanding

Education

Bachelor's Degree or equivalent

Job description

Centene Management Company LLC seeks a provider education and quality improvement professional to educate physicians and IPAs on NCQA HEDIS measures and risk adjustment, supporting documentation and coding across plan providers.

This role involves travel up to 75% to provider offices, collaboration with Provider Relations, and ongoing education to improve HEDIS performance and plan compliance with state and federal standards.