HEDIS & Risk Adjustment Advisor - Provider Education (LA)

Louisiana Healthcare Connections, Inc.; New Orleans (LA); On-site; USD 37,000 - 67,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Job summary

Centene is seeking a healthcare quality professional to educate and support provider practices on HEDIS measures, documentation, and coding. The role focuses on data collection, performance trends, and coaching for provider improvement.

Success requires strong HEDIS/risk adjustment experience, collaboration with provider relations, and the ability to travel up to 75% across Louisiana. Bachelor’s degree is required with applicable certifications preferred.

Qualifications

• Bachelor's Degree or equivalent required.
• 3+ years in HEDIS record collection and risk adjustment (coding) required.
• CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS certifications may be required.
• RHIT certification may apply to corporate roles in state-specific plans.

Responsibilities

• Delivers, educates and advises provider practices and IPAs on HEDIS measures and coding.
• Collects and summarizes provider quality and risk adjustment performance data.
• Collaborates with Provider Relations to improve performance in Quality, Risk Adjustment and Operations.
• Identifies provider needs where Centene can provide support.
• Develops and maintains provider clinical relationships across product lines.
• Travel up to 75% to provider offices.

Skills

HEDIS knowledge

Provider education

Data analysis

Education

Bachelor's Degree

HEDIS/Risk Adjustment experience

RHIT

CCS/CPC etc. certifications

Tools

None

Job description

Centene is seeking a healthcare quality professional to educate and support provider practices on HEDIS measures, documentation, and coding. The role focuses on data collection, performance trends, and coaching for provider improvement.

Success requires strong HEDIS/risk adjustment experience, collaboration with provider relations, and the ability to travel up to 75% across Louisiana. Bachelor’s degree is required with applicable certifications preferred.