HEDIS Quality Improvement Advisor (Travel)

Centene Corporation; Indiana (PA); Hybrid; USD 37,000 - 68,000; Full time

Job summary

Centene Corporation seeks a Provider Education and HEDIS Specialist to educate providers and IPAs on HEDIS measures, coding and documentation across multiple plan products. The role supports risk adjustment activities, audits, and quality improvement initiatives.

Must be local to Indianapolis, IN with the ability to travel up to 75% to provider offices; bachelor’s degree and 3+ years in HEDIS/risk adjustment are required, with applicable certifications preferred.

Qualifications

• Bachelor's degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• One of the listed licenses/certifications is required.

Responsibilities

• Delivers, advises and educates provider practices and IPAs in HEDIS measures, documentation guidelines and coding.
• Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify improvement opportunities.
• Collaborates with Provider Relations and other teams to improve provider performance in Quality, Risk Adjustment and Operations.
• 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 standards.
• Travel up to 75% to provider offices.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

HEDIS knowledge

Risk adjustment coding

Provider education

Travel up to 75%

Education

Bachelor's Degree or equivalent

Job description

Centene Corporation seeks a Provider Education and HEDIS Specialist to educate providers and IPAs on HEDIS measures, coding and documentation across multiple plan products. The role supports risk adjustment activities, audits, and quality improvement initiatives.

Must be local to Indianapolis, IN with the ability to travel up to 75% to provider offices; bachelor’s degree and 3+ years in HEDIS/risk adjustment are required, with applicable certifications preferred.