HEDIS & Quality Practice Advisor (Remote/Hybrid)

Centene Corporation; United States; Hybrid; USD 37,000 - 67,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Remote, hybrid, field or office work

Job summary

Centene Corporation seeks a Provider Quality Improvement specialist to educate and support provider practices on HEDIS measures and proper medical record documentation and coding.

You will collect and analyze performance data, collaborate with Provider Relations, and drive improvements in quality and risk adjustment across networks. Travel up to 75% is required, with flexible scheduling options.

Qualifications

• Bachelor’s degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• HEDIS coding with ICD-9/10 and CPT guidelines experience preferred.

Responsibilities

• Delivers, educates and advises provider practices on HEDIS measures and coding.
• Collects, summarizes, trends and reports provider quality and risk adjustment performance.
• Collaborates with Provider Relations to improve quality, risk adjustment and operations.
• Identifies provider needs and supports improvement opportunities.
• Maintains provider relationships across product lines and ensures compliance.
• Travel to provider offices as required, up to 75% of the time.

Skills

HEDIS measures

Provider education

Coding (CPT/ICD-9/10)

Risk adjustment

Education

Bachelor's degree or equivalent

Job description

Centene Corporation seeks a Provider Quality Improvement specialist to educate and support provider practices on HEDIS measures and proper medical record documentation and coding.

You will collect and analyze performance data, collaborate with Provider Relations, and drive improvements in quality and risk adjustment across networks. Travel up to 75% is required, with flexible scheduling options.