HEDIS & Risk-Adjustment Advisor (LA)

Louisiana Healthcare Connections, Inc.; Louisiana; Hybrid; USD 37,000 - 67,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Job summary

Centene seeks a HEDIS and risk adjustment professional in Louisiana to educate providers, support NCQA HEDIS measures and ensure proper medical record documentation and coding. You will analyze performance data and work with provider relations to identify improvement opportunities and close gaps.

The role requires a Bachelor’s degree or equivalent and at least 3 years’ experience in HEDIS record collection and risk adjustment, with the ability to travel up to 75% to provider offices.

Qualifications

• Bachelor's Degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.

Responsibilities

• Delivers, advises and educates provider practices and IPAs in HEDIS measures, documentation guidelines and coding.
• Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data.
• Collaborates with Provider Relations to improve provider performance in Quality, Risk Adjustment and Operations.
• Identifies practice needs where Centene can provide support.
• Develops and maintains provider clinical relationships across product lines.
• Maintains Quality KPI and HEDIS abstraction accuracy rates.
• Travels up to 75% to provider offices.
• Complies with all policies and performs other duties as assigned.

Skills

HEDIS experience

Risk adjustment

Coding knowledge

Provider education

Education

Bachelor's Degree or equivalent

Job description

Centene seeks a HEDIS and risk adjustment professional in Louisiana to educate providers, support NCQA HEDIS measures and ensure proper medical record documentation and coding. You will analyze performance data and work with provider relations to identify improvement opportunities and close gaps.

The role requires a Bachelor’s degree or equivalent and at least 3 years’ experience in HEDIS record collection and risk adjustment, with the ability to travel up to 75% to provider offices.