HEDIS Quality Practice Advisor — Remote/Hybrid Travel

Iowa Total Care; Iowa (LA); Hybrid; USD 37,000 - 68,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K

Stock purchase plans

Tuition reimbursement

Paid time off + holidays

Flexible work arrangements

Job summary

Centene is seeking a Provider Quality & HEDIS Specialist to foster relationships with large physician practices and IPAs, educating them on NCQA HEDIS measures and risk adjustment. The role supports documentation, coding accuracy and plan compliance with state and federal standards.

Travel to provider offices up to 75% and collaborate with provider relations to improve performance across Quality, Risk Adjustment, and Operations. Requires a Bachelor's degree and 3+ years in HEDIS.

Qualifications

• Bachelor's degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• Certifications: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS.

Responsibilities

• Educates providers and supports NCQA HEDIS measures and risk adjustment.
• Delivers provider education on medical record documentation and coding.
• Collects, summarizes and trends provider quality data to identify opportunities for improvement.
• Travel up to 75% to provider offices.
• Maintain KPI and HEDIS abstraction accuracy.

Skills

Provider education

Stakeholder communication

Data interpretation

Education

Bachelor's degree or equivalent

3+ years HEDIS record collection and risk adjustment

Tools

CCS

LPN

RN

CPC

Job description

Centene is seeking a Provider Quality & HEDIS Specialist to foster relationships with large physician practices and IPAs, educating them on NCQA HEDIS measures and risk adjustment. The role supports documentation, coding accuracy and plan compliance with state and federal standards.

Travel to provider offices up to 75% and collaborate with provider relations to improve performance across Quality, Risk Adjustment, and Operations. Requires a Bachelor's degree and 3+ years in HEDIS.