HEDIS Quality Practice Advisor — Travel‑Heavy Role

Centene Corporation; New York (NY); Hybrid; USD 37,000 - 67,000; Full time

Job summary

Centene Corporation seeks a qualified professional to establish and nurture productive relationships with large physician practices and IPAs, educating them on HEDIS measures, proper medical record documentation, and coding practices. The role involves data collection, trend analysis, and coaching on performance improvement, with significant travel across the region.

You will collaborate with provider-facing teams to uplift quality, risk adjustment, and operational outcomes, while maintaining

Qualifications

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

Responsibilities

• Educates providers and supports provider sites on NCQA HEDIS measures, documentation and coding.
• Delivers provider quality and risk adjustment performance data and identifies opportunities for improvement.
• Collaborates with Provider Relations and other teams to enhance provider performance in quality, risk adjustment, and operations.
• Travels to provider offices up to 75% to deliver education and support.
• Maintains quality KPI and adheres to HEDIS abstraction accuracy standards.

Skills

HEDIS knowledge

Risk adjustment coding

Medical record documentation

Education

Bachelor's degree or equivalent

Job description

Centene Corporation seeks a qualified professional to establish and nurture productive relationships with large physician practices and IPAs, educating them on HEDIS measures, proper medical record documentation, and coding practices. The role involves data collection, trend analysis, and coaching on performance improvement, with significant travel across the region.

You will collaborate with provider-facing teams to uplift quality, risk adjustment, and operational outcomes, while maintaining