HEDIS Quality Practice Advisor (Travel-Heavy)

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

Benefits offered by this job

Health insurance

401K plan

Stock purchase plan

Tuition reimbursement

Paid time off

Job summary

Centene Corporation is seeking a Quality Education Specialist focused on HEDIS measures. The role educates community physicians and small practices on HEDIS documentation, coding, and NCQA requirements.

You will analyze provider performance data to drive improvements and collaborate with Provider Relations on quality and operations outcomes. The ideal candidate has a relevant degree, HEDIS review or medical coding experience, and strong communication skills to educate providers and staff.

Qualifications

• Bachelor’s degree in Healthcare, Public Health, Nursing, Psychology, Health Administration, Social Work or related field or equivalent work experience.
• Master’s Degree preferred; 1+ year of related HEDIS medical record review or quality improvement experience OR 2 years medical coding or transferable experience.

Responsibilities

• Educates community physicians and small provider practices in HEDIS measures and coding per NCQA requirements.
• Collects and trends provider performance data to identify improvement opportunities.
• Collaborates with Provider Relations to improve Quality, Risk Adjustment and Operations outcomes.
• Delivers provider-specific metrics and coaches on gap closing opportunities.
• Ensures documentation aligns with state regulations and accrediting bodies.

Skills

HEDIS measures

Medical record review

Provider education

Coding guidance

Education

Bachelor's degree

Master's degree preferred

Tools

CPT coding

Job description

Centene Corporation is seeking a Quality Education Specialist focused on HEDIS measures. The role educates community physicians and small practices on HEDIS documentation, coding, and NCQA requirements.

You will analyze provider performance data to drive improvements and collaborate with Provider Relations on quality and operations outcomes. The ideal candidate has a relevant degree, HEDIS review or medical coding experience, and strong communication skills to educate providers and staff.