HEDIS Quality Practice Advisor (Remote—TX)

Centene Corp.; Town of Texas (WI); Hybrid; USD 37,000 - 68,000; Full time

Job summary

Centene Corp. seeks a Quality Practice Advisor to educate and support provider practices and IPAs on HEDIS measures, documentation guidelines, and accurate coding. The role involves analyzing quality and risk data and coaching on performance gaps to meet NCQA and state standards.

The position is hybrid with remote duties and requires travel up to 75% to provider sites, primarily in Texas, with preference for East Texas. A Bachelor’s degree and HEDIS experience are essential.

Qualifications

• Bachelor's Degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• One of the approved licenses/certifications (CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS) is required.

Responsibilities

• Delivers, advises and educates provider practices and IPAs in HEDIS measures and documentation.
• Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data.
• Travel up to 75% to provider offices and collaborate with provider relations teams.

Skills

HEDIS knowledge

Education

Bachelor's Degree or equivalent

Tools

CCS/LPN/LCSW/LMHC/LMSW/LMFT/LVN/RN/APRN/HCQM/CHP/CPHQ/CPC/CPC-A/CBCS

Job description

Centene Corp. seeks a Quality Practice Advisor to educate and support provider practices and IPAs on HEDIS measures, documentation guidelines, and accurate coding. The role involves analyzing quality and risk data and coaching on performance gaps to meet NCQA and state standards.

The position is hybrid with remote duties and requires travel up to 75% to provider sites, primarily in Texas, with preference for East Texas. A Bachelor’s degree and HEDIS experience are essential.