HEDIS Quality Practice Advisor – Provider Education

Centene Corp.; Michigan; Hybrid; USD 37,000 - 67,000; Full time

Benefits offered by this job

Health insurance

401K + stock purchase plans

Tuition Reimbursement

Paid time off + holidays

Flexible work arrangements

Job summary

Centene Corp. is hiring an Associate Quality Practice Advisor to partner with community physicians and small provider practices across Southwest Michigan.

The role focuses on HEDIS education, medical record documentation guidelines, and NCQA coding standards to support plan compliance. You will collect and trend provider performance data, collaborate with Provider Relations to close gaps, and coach staff on quality improvement.

Qualifications

• Bachelor's degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field
• Experience in HEDIS medical record review or quality improvement is required

Responsibilities

• Educates providers on HEDIS measures, medical record documentation guidelines and NCQA coding.
• Collects and trends provider performance data to identify opportunities for improvement.
• Collaborates with Provider Relations to improve performance in Quality, Risk Adjustment and Operations.
• Coaches providers on gap-closing opportunities and documents action plans.

Skills

HEDIS measures

Provider education

Medical coding

Data analysis

Quality improvement

NCQA guidelines

Provider relations

Education

Bachelor's degree in healthcare/related field

Master's degree preferred

Tools

NCQA coding knowledge

Job description

Centene Corp. is hiring an Associate Quality Practice Advisor to partner with community physicians and small provider practices across Southwest Michigan.

The role focuses on HEDIS education, medical record documentation guidelines, and NCQA coding standards to support plan compliance. You will collect and trend provider performance data, collaborate with Provider Relations to close gaps, and coach staff on quality improvement.